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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Stent-induced compression necrosis for the endoscopic removal of a partially eroded Lap-Band
  1. Ali Talib1,
  2. Rogier de Ridder2,
  3. Jan Willem Straathof2,
  4. Nicole D Bouvy1
  1. 1 Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2 Department of Gastroenterology, Maastricht University Medical Centre, Maastricht, The Netherlands
  1. Correspondence to Professor Nicole D Bouvy, n.bouvy{at}mumc.nl

Summary

Endoscopic removal of eroded Lap-Bands is a minimally invasive alternative to surgical removal that prerequires sufficient erosion through the gastric wall, that is, ≥180° of the gastro-oesophageal wall circumference. A 69-year-old woman presented with dysphagia due to a long-standing Lap-Band erosion, currently of a 60° circumference. Adhesions due to her extensive surgical history rendered surgical treatment undesirable, so a self-expanding stent was placed endoscopically to induce sufficient erosion for subsequent endoscopic removal. During therapy, the patient complained of ructus and dysphagia, probably related to an overly proximally (oesophageal) positioned stent. After a total of 12 weeks, far longer than the described stenting duration in the literature, the Lap-Band was found free in the gastric lumen and was successfully removed using an endoscopic loop. Stent-induced compression necrosis should be considered as a minimally invasive treatment option for Lap-Bands eroded for <180°, with caution in the context of extensive fibrosis.

  • gi-stents
  • gastroenterology
  • surgery
  • endoscopy

https://doi.org/10.1136/bcr-2018-224670

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    Footnotes

    • Contributors AT wrote this article. The gastroenterologists who performed the endoscopic extraction were RdR and JWS. The primary caregiver of the patient was NDB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.