Stent induced gastric erosion for endoscopic retrieval of nonadjustable gastric band

Harvey Rainville, MD, Hossain Bagshahi, MD, Todd Wilson, MD, Brad Snyder, MD, Erik B Wilson, MD

University of Texas at Houston Medical School

Introduction: There are many types of fixed bands used for restriction in bariatric surgery with a multitude of reasons for the removal those bands. While Marlex or non silastic material bands can be extremely difficult to remove other challenges to removing fixed bands include the difficulty in locating the band, inability to remove all of the band, and damage to surrounding structures including gastrotomies. Removing eroded bands endoscopically may pose less risk, thereby supporting forced erosion as an easier modality than surgery, allowing revision without having to deal with the actual band at the time of definitive revision surgery.

Methods: A retrospective case series developed from a university single institution bariatric practice setting was utilized. Endpoints in the study for each type of stent included success rate of band removal, number and type of complications experienced, and length of time the stent was present.

Results: A total of 15 consecutive cases utilizing endoscopic stenting to actively induce fixed gastric band erosion for subsequent endoscopic removal were reviewed. There was an overall 87% success rate in complete band removal with partial removal of the remaining bands that resolved the patient’s symptoms. An overall complication rate of 27% (limited to pain and/or nausea and vomiting) was recorded and the mean time period of the placement of the stent prior to removal or attempted removal was 16.3 days.

Conclusion: Endoscopic forced erosion of fixed gastric bands is feasible, safe, and may offer an advantage over laparoscopic removal. This technique is especially applicable for gastric obstruction from fixed bands, prior to large and definitive revision surgeries, or anticipated hostile anatomy that might preclude an abdominal operation altogether.

Session: Poster Presentation

Program Number: ETP078

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