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Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures

2009; Elsevier BV; Volume: 71; Issue: 3 Linguagem: Inglês

10.1016/j.gie.2009.06.020

1097-6779

Daniel Bléro, Pierre Eisendrath, Alain Vandermeeren, Jean Closset, Abdel Ilah Mehdi, Olivier Le Moine, Jacques Devière,

Gastroesophageal reflux and treatments

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.In this series, we describe the endoscopic removal of partially eroded Lap-Bands or Silastic rings and noneroded dysfunctioning rings after VBG.Case series.A European, tertiary-care academic center.This study involved 13 patients--3 with eroded Lap-Bands, 4 with eroded Silastic rings, and 6 with refractory outlet stoma stenosis after VBG.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.Technical success and safety.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.Highly selected patients (tertiary-case academic center).Endoscopic removal of dysfunctioning bands or rings is safe and feasible by the use of a 1- or 2-step endoscopic procedure.