Surgical Endoscopy

, Volume 27, Issue 5, pp 1617–1621

Stent induced gastric wall erosion and endoscopic retrieval of nonadjustable gastric band: a new technique

  • Todd D. Wilson
  • Nathan Miller
  • Nicholas Brown
  • Brad E. Snyder
  • Erik B. Wilson
Article

Abstract

Introduction

In gastrointestinal surgery, specifically in bariatric surgery, there are many types of fixed bands used for restriction and there are a multitude reasons that might eventually be an impetus for the removal of those bands. Bands consisting of Marlex or non silastic materials can be extremely difficult to remove. Intraoperative complications removing fixed bands include the difficulty in locating the band, inability to remove all of the band, and damage to surrounding structures including gastrotomies. Removal of eroded bands endoscopically may pose less risk. Potentially, forced erosion may be an easier modality than surgery, allowing revision without having to deal with the actual band at the time of definitive revision surgery.

Methods

A retrospective case series developed from a university single institution bariatric practice setting was utilized. Endpoints for the study include success of band removal, complications, length of time the stent was present, and the type of stent.

Results

A total of 15 consecutive cases utilizing endoscopic stenting to actively induce fixed gastric band erosion for subsequent endoscopic removal were reviewed. There was an 87 % success rate in complete band removal with partial removal of the remaining bands that resolved the patient’s symptoms. A complication rate of 27 % was recorded among the 15 patients, consisting of pain and/or nausea and vomiting. The mean time period of the placement of the stent prior to removal or attempted removal was 16.3 days.

Conclusion

Endoscopic forced erosion of fixed gastric bands is feasible, safe, and may offer an advantage over laparoscopic removal. This technique is especially applicable for gastric obstruction from fixed bands, prior to large and definitive revision surgeries, or anticipated hostile anatomy that might preclude an abdominal operation altogether.

Keywords

Bariatric Digestive Obesity Band erosion 

References

  1. 1.
    Linner JH (1984) Gastric operations: specific techniques. In: Linner JH (ed) Surgery for morbid obesity. Springer, New York, pp 65–91CrossRefGoogle Scholar
  2. 2.
    Wilkinson LH (1980) Reduction of gastric reservoir capacity. Am J Clin Nutr 33:151–157Google Scholar
  3. 3.
    Oria HE (2009) Gastric segmentation: nonadjustable banding by minilaparotomy: historical review. Surg Obes Relat Dis 5:365–370PubMedCrossRefGoogle Scholar
  4. 4.
    Wolf AM, Kortner B, Kuhlmann HW (2001) Results of bariatric surgery. Int J Obes Relat Metab Disord 25(Suppl 1):S113–S114PubMedCrossRefGoogle Scholar
  5. 5.
    Vassallo C, Andreoli M, La Manna A, Turpini C (2001) 60 reoperations on 890 patients after gastric restrictive surgery. Obes Surg 11(6):752–756PubMedCrossRefGoogle Scholar
  6. 6.
    Steffen R (2008) The history and role of gastric banding. Surg Obes Relat Dis 4:S7–S13PubMedCrossRefGoogle Scholar
  7. 7.
    Miller K, Pump A, Emanuel H (2007) Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow up study. Surg Obes Relat Dis 3(1):84–90PubMedCrossRefGoogle Scholar
  8. 8.
    Karmali S, Sweeney JF, Yee K, Brunicardi C, Sherman V (2008) Transgastric endoscopic rendezvous technique for removal of eroded Molina gastric band. Obes Surg 4(4):559–562CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Todd D. Wilson
    • 1
  • Nathan Miller
    • 1
  • Nicholas Brown
    • 1
  • Brad E. Snyder
    • 1
  • Erik B. Wilson
    • 1
  1. 1.Department of SurgeryUniversity of Texas Health Sciences Center at HoustonHoustonUSA

Personalised recommendations