ENDOSCOPIC REMOVAL OF MIGRATED ADJUSTABLE GASTRIC BANDING

V Bove; I Boškoski; A Tringali; R Landi; P Familiari; V Perri; G Costamagna

doi:10.1055/s-0039-1681251

Endoscopy, Inhaltsverzeichnis

Endoscopy 2019; 51(04): S28
DOI: 10.1055/s-0039-1681251

ESGE Days 2019 oral presentations

Friday, April 5, 2019 08:30 – 10:30: Video upper GI 1 South Hall 1B

Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC REMOVAL OF MIGRATED ADJUSTABLE GASTRIC BANDING

Authors

V Bove

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
I Boškoski

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
A Tringali

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
R Landi

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
P Familiari

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
V Perri

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
G Costamagna

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy

Abstract

Volltext

Background and aims:

Intragastric band migrations or dysfunctions are common long-term complications of laparoscopic adjustable gastric banding (Lap-Band) that classically require surgical treatment. In this video case we describe the endoscopic removal of partially eroded Lap-Bands.

Material and methods:

We present the case of a 61 years-old female that underwent a Lap-Band in 2002 for morbid obesity (weight 150 Kg, BMI 55.1). In November 2017 she had abdominal pain and an EGD showed erosion of the gastric mucosa and partial intragastric migration of the Lap-Band (> 50%). After surgical removal of the subcutaneous reservoir an endoscopic procedure was planned to remove the migrated gastric band. The procedure was performed under general anesthesia, with CO2 insufflation and using a therapeutic gastroscope (GIF-1T 160, Olympus, Japan).

Results:

The ring was captured with a guidewire (Jagwire, Boston Scientific, Marlborough, MA) under endoscopic control and fluoroscopic control in a "loop shape". The endoscope was then removed, and a mechanical lithotripter (Endobair, London, UK) was placed over the 2 extremities of the wire and a biliary lithotripsy device was used to cut the migrated band. The band was pushed into the stomach, captured with a snare and pulled out. There were no procedure related complications.

Conclusions:

Endoscopic removal of intragastric migrated Lap-Band is safe, repeatable and procedure and is a valide alternative over surgery.