title: Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepato-pancreatology, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Blero
authors.forename: Pierre
authors.initials: P
authors.lastname: Eisendrath
authors.forename: Alain
authors.initials: A
authors.lastname: Vandermeeren
authors.forename: Jean
authors.initials: J
authors.lastname: Closset
authors.forename: Abdel
authors.initials: A
authors.lastname: Mehdi
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Moine
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
mesh_terms: 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