Post written by Saurabh Chawla, MD, from the Emory University School of Medicine, Atlanta, Georgia, USA.
We present a case of a patient presenting with abdominal pain who had a sleeve gastrectomy with silastic band placement several years prior to his presentation. Upon further investigation, the silastic band was noted to be eroding into the gastric lumen. We describe the techniques and tools used to endoscopically remove the eroding silastic band.
Silastic bands have been utilized in various bariatric operations in the past. It allowed restriction of the gastric pouch which promoted weight loss. Over the past few years, band erosions are being increasingly recognized as a complication of these types of procedures resulting in weight regain, bleeding, and abdominal pain. For these reasons, such bands are no longer recommended during bariatric surgeries. However, patients with remote history of restrictive bariatric surgeries continue to present with complete or partial band erosions. With the technologies available today, we are able to extract these types of bands endoscopically, potentially sparing patients the morbidity associated with surgery.
Endoscopists should be aware of the different types of restrictive bariatric devices that could potentially be removed safely endoscopically should complications occur and also those which cannot be removed endoscopically (eg, inflatable laparoscopic gastric bands). They should also be aware of the techniques used to retrieve these devices which include traction, identifying the sutures connecting these bands, and tools used, such as endoscissors, to transect these sutures allowing easy retrieval.
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