title: Endoscopic management of gastric band erosions: a 7-year series of 14 patients.
abstract: BACKGROUND
  Intragastric band migration is an unusual but major complication of gastric banding. We review our experience with endoscopic removal of eroded gastric bands.
  
  
  METHODS
  We retrospectively evaluated the cases of 110 morbidly obese patients who underwent adjustable gastric banding between 2005 and 2012 to identify those who experienced band erosion. To remove the migrated band, we used an endoscopic approach with a Gastric Band Cutter.
  
  
  RESULTS
  Band or tube erosion occurred in 14 patients (12.7%). The median time interval from the initial gastric band placement to the diagnosis of band erosion was 32 (range 18-52) months. Upper abdominal pain, port site infection, loss of restriction and weight regain were the most common symptoms. We used the Gastric Band Cutter to remove the band endoscopically. It was able to cut the band successfully in all but 1 patient, in whom twisting of the cutting wire required conversion from endoscopy to laparotomy. In 2 patients, the band, after being cut, was locked in the gastric wall and required laparotomic removal. In 1 patient, we performed surgery for intragastric penetration of the connecting tube broken close to the band.
  
  
  CONCLUSIONS
  The Gastric Band Cutter was successful in dividing the band in all but 1 patient, although we could not always complete the procedure endoscopically. Endoscopic removal seems to be effective and safe for band erosion.
authors.affiliation: The Department of Gastroenterology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ümit Bilge
authors.initials: ÜB
authors.lastname: Dogan
authors.affiliation: The Department of Gastroenterology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Mustafa Salih
authors.initials: MS
authors.lastname: Akin
authors.affiliation: The Department of Gastroenterology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Yalaki
authors.affiliation: The Department of Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Akova
authors.affiliation: The Department of Radiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D015992:Body Mass Index; D020878:Device Removal; D004724:Endoscopy; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome