Laparoscopic Adjustable Silicone Gastric Banding (LASGB) has become a popular surgical technique for treatment of morbid obesity. Failure to achieve and maintain adequate weight loss may require revision to gastric bypass, which has been associated with increased complications. We report on 4 patients (all female) who failed LASGB and were revised to gastric bypass with the deflated band left in position and gastric transection performed inferior to it. Patients underwent a 75 x 150 cm Roux limb bypass in the retrocolic and retrogastric position. Patients lost 40%, 43% and 51% of excess weight at follow up of 7, 8, 12 and 46 months respectively. Patients lost an average of 61.5% (53.2% - 77.3%) of excess BMI. The patient who lost 51% of her excess weight at 46 months still has BMI>40 and band adjustment is now being undertaken to increase restriction. There were no serious peri-operative or long-term complications or mortality. One patient was re-operated for a breakage of the tubing from the port of the LASGB, which was repaired laparoscopically. The tubing was reconnected to the port. No patients were lost to follow up. These results indicate that banded Roux-en-Y gastric bypass performed below a previously placed LASGB may be an attractive strategy for revision in patients who fail LASGB.