Gastroscopic band removal after intragastric migration of adjustable gastric band: A new minimal invasive technique

Background: Laparoscopic adjustable gastric banding (LAGB) rs the most used procedure for bariatric surgery in Europe, Although a tow complication rat e 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 i ncreased risk of complications due to laparotomy, we propose a minimally in vasive technique for this purpose. Methods: We performed this operation in five patients who suffered from ban d migration after LAGB (1.9% in our series of 211 patients, one patient was operated elsewhere), The described method consists of gastroscopic band an d tube removal, combined with removal of the port under local anesthesia, Results: The described procedure was developed in the endoscopy unit withou t additional equipment, The mean operating-time ranged from 65 to 180 minut es (mean 135 minutes). No perioperative complication were observed. In-pati ent treatment was necessary for 4 days. Conclusions: A novel technique for minimally invasive band removal after ad justable gastric band migration is described, offering the patient a low-ri sk procedure and a better chance for further laparoscopic approaches.