Ryan K Lehmann, DO, Norbert L Richardson, MD. St. Alexius Hospital
Background: Laparoscopic adjustable gastric banding can be complicated by erosion of the band in up to 9 % of patients. Rarely, this can result in migration into the stomach and distal passage. Erosion requires removal either endoscopically or laparoscopically.
Methods: We present a 59 year-old female who underwent a laparoscopic adjustable gastric banding in 2008. She was lost to follow up since 2009 and presented to the clinic with left upper quadrant pain and tenderness. A contrast swallow in clinic failed to show the band in the upper stomach, and the tubing was followed and the band was found much lower than expected. A computed tomography scan showed the band in the proximal jejunum and no free air around the stomach.
Results: The video presented shows the steps to treat an eroded and migrated band: Preoperative localization of the band with imaging, intraoperative localization in the small bowel, enterotomy and removal of the band from the small bowel, division of the proximal tubing, complete removal of the band, and closure of the enterotomy.
Conclusion: Erosion of an adjustable gastric band is a possible complication of the procedure and migration is rare. Laparoscopic treatment of this rare complication is feasible and can be carried out safely by following several key steps.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78739
Program Number: V209
Presentation Session: Video Loop
Presentation Type: VideoLoop