Gastroscopic Band Removal after Intragastric Migration of Adjustable Gastric Band: A New Minimal Invasive Technique

Background: Laparoscopic adjustable gastric banding (LAGB) is the most used procedure for bariatric surgery in Europe. Although a low complication rate is reported, band migration within the first 2 years after LAGB is still observed in nearly 5% of cases, requiring operative band removal.To avoid increased risk of complications due to laparotomy, we propose a minimally invasive technique for this purpose. Methods: We performed this operation in five patients who suffered from band migration after LAGB (1.9% in our series of 211 patients, one patient was operated elsewhere). The described method consists of gastroscopic band and tube removal, combined with removal of the port under local anesthesia. Results: The described procedure was developed in the endoscopy unit without additional equipment. The mean operating-time ranged from 65 to 180 minutes (mean 135 minutes). No perioperative complication were observed. In-patient treatment was necessary for 4 days. Conclusions: A novel technique for minimally invasive band removal after adjustable gastric band migration is described, offering the patient a low-risk procedure and a better chance for further laparoscopic approaches.