Advertisement

Obesity Surgery

, Volume 20, Issue 6, pp 796–800 | Cite as

Simultaneous Gastric and Colic Laparoscopic Adjustable Gastric Band Migration. Complication of Bariatric Surgery

  • Antónia Afonso PóvoaEmail author
  • Carlos Soares
  • Joana Esteves
  • António Gandra
  • Rui Maciel
  • João M. Cardoso
  • Lurdes Gandra
  • Jorge P. Maciel
Case Report

Abstract

Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive treatment for morbid obesity, which has proved its safety, efficiency, and reversibility. Postoperative complications are rare and might be related with the reservoir, connecting tube, or with the band itself. The lack or unspecificity of clinical signs and symptoms makes the diagnosis of gastric band erosion difficult. The authors present the case of a 54-year-old female, submitted to laparoscopic adjustable gastric banding in April 2004 (BMI = 40 kg/m2). During the first year, she reduced her body mass index to 30 and remained stable thereafter. In August 2008, while investigating a moderate colicky abdominal pain, she was submitted to a colonoscopy that showed part of the band inside the transverse colon. Two exams were performed: the abdominal CT scan, which showed the connecting tube inside the transverse colon lumen and the lap band which was apparently well positioned around the stomach, and an upper digestive endoscopy that revealed band migration to the stomach lumen. The patient underwent laparoscopic band removal and closure of both stomach and colon walls, thus treating the fistula. LAGB erosion and migration is a late complication of this surgery that frequently needs surgical removal. LAGB migration to colon or stomach is described in literature isolated. Simultaneous erosion to stomach and colon lumen, with a gastrocolic fistula formation, has never been described before, making this case a unique one.

Keywords

Laparoscopic adjustable gastric banding Bariatric surgery Complication Fistula 

Notes

Acknowledgements

The authors would like to thank Eng. Carlos Lima for all help and support in the preparation of this paper.

References

  1. 1.
    Stroh C, Hohmann U, Will U, et al. Experiences of two centers of bariatric surgery in the treatment of intragastrale band migration after gastric banding—the importance of the German multicenter observational study for quality assurance in obesity surgery 2005 and 2006. Int J Colorectal Dis. 2008;23:901–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Suter M, Bettschart V, Giusti V, et al. A 3-year experience with laparoscopic gastric banding for obesity. Surg Endosc. 2000;14:532–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Lim CSH, Liew V, Talbot ML, et al. 2008 Revisional bariatric surgery. Obes surg;19(7):827–832. PMID: 18972173Google Scholar
  4. 4.
    Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg. 2003;4:536–47.CrossRefGoogle Scholar
  5. 5.
    Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16:829–35.CrossRefPubMedGoogle Scholar
  6. 6.
    Keidar A, Carmon E, Szold A, et al. Port complications following laparoscopic adjustable gastric banding for morbid obesity. Obes Surg. 2005;15:361–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Abu-Abeid S, Zohar DB, Sagie B, et al. Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Obes Surg. 2005;15:849–52.CrossRefPubMedGoogle Scholar
  8. 8.
    Szold A, Abu-Abeid S. Laparoscopic adjustable silicone gastric banding for morbid obesity—results and complications in 715 patients. Surg Endosc. 2002;16:230–3.CrossRefPubMedGoogle Scholar
  9. 9.
    Hartmann J, Scharfenberg M, Paul M, et al. Intracolonic penetration of the adjustable gastric banding tube. Obes Surg. 2006;16:203–5.CrossRefPubMedGoogle Scholar
  10. 10.
    O’Brien PE, Dixon JB. Weight loss and early and late complications—the international experience. Am J Surg. 2002;184:42S–5S.CrossRefPubMedGoogle Scholar
  11. 11.
    De Palma GD, Formato A, Pilone V, et al. Endoscopic management of intragastric penetrated adjustable gastric band for morbid obesity. World J Gastroenterol. 2006;12(25):4098–100.PubMedGoogle Scholar
  12. 12.
    Zehetner J, Holzinger F, Triaca H, et al. A 6-year experience with the Swedish adjustable gastric band—prospective long-term audit of laparoscopic gastric banding. Surg Endosc. 2005;19:21–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Tekin A. Migration of the Connecting Tube into Small Bowel after Adjustable Gastric Banding. Obes Surg. 2009;18.Google Scholar
  14. 14.
    Sneider R, Cense HA, Hunfeld M, et al. A rare complication after laparoscopic gastric banding: connecting-tube penetration into the hilus of the kidney. Obes Surg. 2009;19(4):531–3.CrossRefGoogle Scholar
  15. 15.
    Sauerland S, Angrisani L, Belachew M, et al. Obesity surgery—evidence-based guidelines of the European Association for Endoscopic Surgery (E.A.E.S.). Surg Endosc. 2005;19:200–21.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Antónia Afonso Póvoa
    • 1
    • 3
    Email author
  • Carlos Soares
    • 1
  • Joana Esteves
    • 1
  • António Gandra
    • 1
  • Rui Maciel
    • 1
  • João M. Cardoso
    • 1
  • Lurdes Gandra
    • 1
  • Jorge P. Maciel
    • 2
    • 1
  1. 1.General Surgery DepartmentCentro Hospitalar de Vila Nova de Gaia/Espinho, EPEVila Nova de GaiaPortugal
  2. 2.Fernando Pessoa UniversityPortoPortugal
  3. 3.Serviço de Cirurgia GeralCentro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Rua Conceição FernandesVila Nova de GaiaPortugal

Personalised recommendations