title: Management of a jejunal obstruction caused by the migration of a laparoscopic adjustable gastric banding. A case report.
abstract: BACKGROUND
  We present a rare case of jejunal obstruction due to the migration of a laparoscopic adjustable gastric band (LAGB) that occurred 10 years after surgery and was successfully treated by laparoscopy. This report is compliant with the SCARE guidelines.
  
  
  METHODS
  A 42-year-old woman who underwent LAGB for morbid obesity 10 years ago was admitted with a small bowel obstruction due to the migration of a LAGB in the proximal small bowel. An attempt to endoscopic removal was unsuccessful and resulted in a laparoscopic extraction of the band. The post-operative course was uneventful.
  
  
  CONCLUSIONS
  Formerly, LAGB was considered the safest technique in bariatric surgery. However, the rate of complication increases in long-term studies. When the IGM of the band is diagnosed, removal is the only issue. Small bowel obstruction caused by a migrated band appears to be a rare complication following IGM, and the only therapeutic option is surgery because an endoscopic procedure is not reliable. Furthermore, LAGB appears to be a less effective technique for weight loss than the sleeve gastrectomy and the gastric bypass.
  
  
  CONCLUSIONS
  Small bowel obstruction caused by LAGB migration is a rare but serious complication following IGM. In such cases, endoscopy has to be avoided because of the risk of jejunal disruption. The only way to treat it properly is surgery. This type of late complication reinforces the interest in the techniques currently used in bariatric surgery such as sleeve gastrectomy and gastric bypass, providing also a better weight loss than the LAGB.
authors.affiliation: Department of Abdominal Surgery, CHU UcL Namur, University of Louvain, B-5530, Yvoir, Belgium. Electronic address: lemaire_julien@yahoo.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Lemaire
authors.affiliation: Department of Hepato-Gastro-Enterology, Cliniques Universitaires Saint-Luc, University of Louvain, B-1200, Woluwe-Saint-Lambert, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dewit
authors.affiliation: Department of Abdominal and Transplantation Surgery, Cliniques Universitaires Saint-Luc, University of Louvain, B-1200, Woluwe-Saint-Lambert, Belgium.
authors.forename: Benoît
authors.initials: B
authors.lastname: Navez
keywords: Band migration; Bariatric surgery; Laparoscopic adjustable gastric banding; Small bowel obstruction