Total Endoscopic Gastric Band Removal

Introduction: Multiple surgical options are available for patients undergoing treatment for obesity. One of the most popular, due to short surgical times and low morbidity, is laparoscopic gastric band placement. Complications necessitating reoperation include prolapse and gastric band erosion. In our video we present a totally endoscopic removal of an eroded gastric band.
Methods: A 61 year old female presented to bariatric surgery clinic with the complaint of abdominal pain. She had had a laparoscopic gastric band placed two years ago by a surgeon in Mexico. On endoscopy, the patient was found to have a complete erosion of her gastric band into her stomach. The patient was taken to the operating room and her port was first removed from her abdominal wall. Next, the endoscope was advanced into her stomach and the decision was made to remove the band endoscopically. An endoscopic guide wire was placed through a hole in the band that was easily accessed though the endoscope. An endoscopic snare then grasped the end of the wire, wrapping it around the band, and pulled it out of the patient’s mouth. An endoscopic lithotripsy overtube was then placed and the ends of the wire attached to the lithotripsy device. Using gentle pressure through the lithotripsy device, the band was divided. With the band completely divided, an end of the band was grasped using the endoscopic snare and removed through the patient’s mouth. On final endoscopy, the stomach showed no sign of perforation or bleeding.
Results: The patient was kept overnight for observation and was discharged home on postoperative day 1. She had no perioperative complications. At one month follow up, she had no complaints.
Conclusion: A total endoscopic removal of an eroded gastric band is important for a bariatric surgeon to have in their armamentarium due to the low morbidity of the procedure.

Session: Podium Video Presentation

Program Number: V007

« Return to SAGES 2010 abstract archive