title: Endoscopic treatment of food intolerance after a banded gastric bypass: inducing band erosion for removal using a plastic stent.
abstract: OBJECTIVE
  Ring complications after a banded Roux-en-Y gastric bypass (RYGB) are usually managed surgically. The aim of this study was to analyze the safety and effectiveness of endoscopic removal of noneroded rings after banded-RYGB, by inducing intragastric erosion of the ring using a self-expandable plastic stent (SEPS).
  
  
  METHODS
  A total of 41 patients with banded RYGB who had noneroded rings and food intolerance were prospectively enrolled. Patients were treated with endoscopic SEPS placement and ring removal. Data from time of stenting, resolution of symptoms, need for endoscopic dilation, and complications were recorded.
  
  
  RESULTS
  Successful ring removal was possible in all patients. In 21 cases, the SEPS induced complete erosion, and in 17 cases the ring was removed a month later because of incomplete erosion at the time of SEPS removal. Nine patients (22.0 %) needed endoscopic dilation after stent removal in order to treat fibrotic strictures. Food tolerance was observed in 32 patients (78.0 %) after the procedure. No patient needed surgery and there were no deaths.
  
  
  CONCLUSIONS
  Endoscopic removal of the ring using SEPS appeared to be safe and effective after a banded RYGB.
authors.affiliation: Department of Bariatric Surgery, Universidade Federal de Pernambuco, Recife, Brazil.
authors.forename: Josemberg
authors.initials: J
authors.lastname: Marins Campos
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando, Florida, United States.
authors.forename: Rena C
authors.initials: RC
authors.lastname: Moon
authors.affiliation: Department of Bariatric Surgery, Universidade Federal de Pernambuco, Recife, Brazil.
authors.forename: Galeno E J
authors.initials: GE
authors.lastname: Magalhães Neto
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando, Florida, United States.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Teixeira
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando, Florida, United States.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Jawad
authors.affiliation: Department of Bariatric Surgery, Universidade Federal de Pernambuco, Recife, Brazil.
authors.forename: Lyz
authors.initials: L
authors.lastname: Bezerra Silva
authors.affiliation: Department of Bariatric Surgery, Gastro Obeso Center, São Paulo, Brazil.
authors.forename: Manoel Galvão
authors.initials: MG
authors.lastname: Neto
authors.affiliation: Department of Bariatric Surgery, Universidade Federal de Pernambuco, Recife, Brazil.
authors.forename: Álvaro Antônio B
authors.initials: ÁA
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000295:instrumentation; D005753:Gastric Mucosa / Q000473:pathology*; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D000069466:Red Meat / Q000009:adverse effects; D015607:Stents; D014839:Vomiting / Q000209:etiology / Q000601:surgery*