Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2015; 21(5): 1567-1572
Published online Feb 7, 2015. doi: 10.3748/wjg.v21.i5.1567
Intragastric band erosion: Experiences with gastrointestinal endoscopic removal
Edo Oscar Aarts, Bas van Wageningen, Frits Berends, Ignace Janssen, Peter Wahab, Marcel Groenen
Edo Oscar Aarts, Bas van Wageningen, Frits Berends, Ignace Janssen, Department of Bariatric Surgery, Rijnstate Hospital, 6800 TA Arnhem, The Netherlands
Peter Wahab, Marcel Groenen, Department of Gastroenterology, Rijnstate Hospital, 6800 TA Arnhem, The Netherlands
Author contributions: Aarts EO, van Wageningen B and Berends F made the study set up and wrote the initial article; Aarts EO gathered all data prospectively; Janssen I, Wahab P and Groenen M corrected the article and helped shaping the final article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Edo Oscar Aarts, MD, PhD, Departments of Bariatric Surgery, Rijnstate Hospital, Vitalys Clinics, Postal No. 1190, PO box 9555, 6800 TA Arnhem, The Netherlands. eaarts@rijnstate.nl
Telephone: +31-8-80058888 Fax: +31-8-80058888
Received: June 13, 2014
Peer-review started: June 13, 2014
First decision: June 27, 2014
Revised: August 11, 2014
Accepted: September 16, 2014
Article in press: September 16, 2014
Published online: February 7, 2015
Processing time: 241 Days and 14.7 Hours
Abstract

AIM: To remove the migrated bands using a gastrointestinal endoscopic approach. Little is published on complications that can occur.

METHODS: From June 2006 to June 2010, eight patients developed intragastric band migration. Two patients had received their AGB in a different hospital, the remaining six were operated by the same surgeon. In all patients gastrointestinal endoscopic removal of the band was attempted by two individual gastroenterologists. Clinical signs of band migration were: persisted nausea, abdominal pain, weight gain, recurrent infection of the port and tubing system and hematemesis.

RESULTS: In four patients removal was performed without complications. In two patients extracting the cleaved gastric band into the stomach appeared impossible. The two remaining patients presented with acute hematemesis and melena. One of these patients was readmitted with hematemesis. The other patient started bleeding during the gastroscopy and was converted to a laparoscopy in which one of the branches of the left gastric artery was oversewn.

CONCLUSION: Band migration after gastric banding can be life threatening. Gastrointestinal endoscopic removal is a feasible technique that holds the promise of fast reconvalescence.

Keywords: Morbid obesity; Adjustable gastric band; Migration; Gastroscopy; Gastrointestinal endoscopic device removal

Core tip: Band migration after gastric banding can be life threatening. Gastrointestinal endoscopic removal is a feasible technique that holds the promise of fast reconvalescence. However, there is a risk for fulminant hemorrhage from the extraction site, even a few weeks after the procedure. It is inadvisable to postpone re-intervention when bleeding is suspected when a patient presents with hematemesis or melena.