Evans JA, Williams NN, Chan EP, Kochman ML., Hepatology. 46(4):1246-56., 2007 Oct 01
Abstract
BACKGROUND: Vertical banded gastroplasty (VBG) as a surgical therapy for morbid
obesity was first described in 1982. VBG involves partitioning the stomach with a
vertical staple line and restricting the outlet pouch with a Gortex band.
Complications of VBG include partial and total erosion of the band through the vertical
staple line or through the lesser curvature into the gastric pouch. Band erosion occurs
after surgery in 1% to 3% of patients, and patients may present with symptoms of obstruction,
weight gain, nausea, pain, and bleeding.
Unless a band has freely eroded
from the stomach wall, allowing spontaneous elimination or simple endoscopic retrieval,
surgical removal has been required heretofore. Previous attempts at endoscopic removal
of eroded bands have included the use of neodymium-yttrium aluminum garnet laser ablation
and other electrosurgical devices.
Endoscopic scissors transection to
remove an eroded laparoscopic band has been described in Europe but has not been performed
in the United States.
OBJECTIVE: In this series, we describe the endoscopic removal of partially eroded bands embedded in the gastric wall by using flexible endoscopic scissors to sever and subsequently withdraw the bands endoscopically through the mouth.
CONCLUSIONS: Eroded gastric bands have been safely removed endoscopically in 2 ambulatory outpatients.
DESIGN: Case series.
SETTING: Tertiary-care academic center.
MAIN OUTCOME MEASUREMENTS: Efficacy and safety.
LIMITATIONS: Highly selected motivated patient population.