Endoscopy 2018; 50(04): S164
DOI: 10.1055/s-0038-1637532
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

REMOVAL OF A MIGRATED GASTRIC BAND USING THE SOEHENDRA BILE STONE LITHOTRIPTER

A Martínez-Alcalá García
1   Hospital Universitario Infanta Leonor, Madrid, Spain
,
PT Kröner
2   Mayo Clinic, Jacksonville, United States
,
KR Kyanam Kabir Baig
3   University of Alabama, Birmingham, United States
,
H Neumann
4   University of Mainz, Mainz, Germany
,
K Mönkemüller
5   Frankenwald Klinik, Kronach, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Laparoscopically placed gastric bands may rarely migrate from outside into the gastric lumen. Usually, open surgery is mandated to remove the migrated band. In addition, there are various endoscopic techniques described to remove a migrated band, but these require expensive or specialized equipment, which is not always readily available. This video demonstrates the steps to remove a migrated gastric band using the Soehendra lithotripter device.

A 58-year-old woman had undergone placement of a gastric band 15-years prior. An EGD performed for dyspepsia revealed that the gastric band had partially migrated into the stomach. The removal procedure was carried out in the operating room and the following six steps were taken to remove the migrated band:

  1. The surgeon released the subcutaneous port;

  2. During esophagogastroduodenosopy (EGD) a biliary (e.g. Metro, Cook, Winston-Salem, North Carolina, USA) was placed around the band;

  3. Both ends of the wire were pulled out of the mouth;

  4. The wire was inserted into the lithotripter cable;

  5. The lithotripter was advanced into the esophagus and stomach and tightened around the band;

  6. The wire and lithotripter cable were tightly pulled around the band using the traditional stone lithotripsy technique, which ultimately results in successful transection; and

  7. The band was then removed with a snare.

The utensils used in our case (Soehendra lithotripter, biliary wires, snares) are readily available in any advanced endoscopy suite. Thus, we believe that this simple technique should be part of the armamentarium of the therapeutic endoscopist.