Connal Robertson-More, MD1, Kieran Purich, MD2, Jerry T Dang, MD2, Aliyah Kanji, MD2, Shahzeer Karmali, MD, MPH2. 1University Hospitals Coventry and Warwickshire NHS Trust, 2University of Alberta
Background: The non-adjustable gastric band was developed by Marcel Molina in 1980 for the treatment of severe obesity. Although demonstrating short term success, this gastric segmentation procedure has generally been abandoned due to complications of gastric stenosis and erosion.
Case: We present a 51 year-old female who had a non-adjustable gastric band placed for severe obesity in 1998. She presented to our clinic with symptoms of proximal gastric outlet obstruction. Further, she was noted to have a low body mass index and malnutrition. Standard preoperative investigations were completed, ultimately showing an eroded non-adjustable gastric band located 2 cm distal to the gastroesophageal junction (GEJ). Following nutritional optimization, the decision was made to remove the band through a modified hybrid technique to relieve her food intolerance and improve her nutritional status.
Technique: A myriad of laparoscopic, endoscopic and hybrid techniques have been described for the removal of eroded gastric bands. Here we describe a modification of an existing hybrid technique which takes advantage of laparoscopic trans-gastric techniques to provide excellent visualization high near the GEJ, endoscopic band removal to minimize the risk of surgical site infection and remains minimally invasive. The use of the laparoscope for visualization within the stomach reduces the technical skill of the procedure compared to the original, making the technique accessible to minimally-invasive surgeons without specialized equipment or specialty trained assistants.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95215
Program Number: V220
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop