A5050 - Difficult Removal of an Eroded Gastric Band: An Unconventional Approach to Minimize Tissue Damage

Abstract

Laparoscopic adjustable gastric banding (LAGB) is a commonly performed weight-loss procedure and has a published long-term complication rate of 16%; 1-3% of these are related to erosion of the band1. The most common manifestations of band erosion are loss of restriction and port site infection and abscess. Gastric band erosion is often associated with inflammation of the surrounding tissues, which can significantly increase the difficulty of surgical or endoscopic removal of the band. We present a case of eroded gastric band complicated by associated port-site abscess and impenetrable adhesions, necessitating a novel surgical approach for safe removal of the band. A 50-year-old female underwent LAGB and had a subsequent 80-pound weight loss over the next 1.5 years. She presented two years after band placement with fever, epigastric pain, and swelling around her access port. She underwent an esophagogastroscopy demonstrating approximately 50% of the band visible in the stomach lumen. She was found to have a large abscess at the port site with marked abdominal tenderness, leukocytosis, and tachycardia. Therefore, we undertook urgent removal of the gastric band.