Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures.
BACKGROUND
Intragastric band migrations or dysfunctions are common long-term complications of both vertical banded gastroplasty (VBG) and laparoscopic adjustable gastric banding (Lap-Band) that classically require surgical treatment.


OBJECTIVE
In this series, we describe the endoscopic removal of partially eroded Lap-Bands or Silastic rings and noneroded dysfunctioning rings after VBG.


METHODS
Case series.


METHODS
A European, tertiary-care academic center.


METHODS
This study involved 13 patients--3 with eroded Lap-Bands, 4 with eroded Silastic rings, and 6 with refractory outlet stoma stenosis after VBG.


METHODS
Endoscopic removal was performed within 1 or 2 sessions, according to the presence and extent of band erosion at presentation, including optional placement of a self-expandable plastic stent across the band, followed about 6 to 8 weeks later by extraction with transsection, if needed, by using a wire-cutting system.


METHODS
Technical success and safety.


RESULTS
One failure was caused by huge adhesion formation around a Lap-Band on the lesser curvature of the stomach and the left liver lobe. Twelve of 13 endoscopic removals were successful in 1 (n = 2) and 2 (n = 10) sessions.


CONCLUSIONS
Highly selected patients (tertiary-case academic center).


CONCLUSIONS
Endoscopic removal of dysfunctioning bands or rings is safe and feasible by the use of a 1- or 2-step endoscopic procedure.
Blero
Daniel
D
Department of Gastroenterology and Hepato-pancreatology, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Eisendrath
Pierre
P
Vandermeeren
Alain
A
Closset
Jean
J
Mehdi
Abdel
A
Le Moine
Olivier
O
Devière
Jacques
J
D000328:Adult; D020878:Device Removal / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D000267:Tissue Adhesions