Endoscopic Management of Silastic Ring Gastric Erosion

Juan P Toro, MD, Nathaniel W Lytle, MD, Ankit D Patel, MD, S. Scott Davis Jr., MD, Edward Lin, DO, MBA. Department of Surgery, Emory University. Atlanta, GA.

Silastic rings have been used to control the outlet of the gastric pouch avoiding dilation and subsequent weight regain. However, this may result in different complications like erosions and migration. Although the reported incidence is low, patients with gastric erosion may present with pain, bleeding, stenosis, and obstruction. Endoscopic removal is the preferred method of treatment although sometimes surgical approach can be required. It is the case of a 38-year-old female patient who had a banded laparoscopic gastric bypass (LGBP) 10 years ago and presented complaining of dysphagia and chronic epigastric pain. A diagnostic EGD showed a silastic ring eroded at least ¾ of circumference into the gastric lumen. We performed an endoscopic management with no complications. The technique and instruments used for endoscopic approach are highlighted in this video.

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