Endoscopic Treatment of an extruded gastric band

We present the case of a patient in whom a gastric band was placed for the treatment of morbid obesity with good results of loss of weight. One year after the procedure the gastric band started to be extruded into the stomach and this was almost total at 26 months. At this time the band was held only by a small tissue bridge. We did two endoscopic procedures to extract the band. In the first one the tissue bridge was cut using the duodenoscope for a better vision and handling and a needle knife papilotome. The band could not be extracted at the time because it continued to be fixed by the connector to the subcutaneous reservoir. The reservoir had been previously removed. One week later in a second procedure the band was cut using a monofilament biliary wire guide and lithotriptor. Then the band could be extracted easily. We describe the procedures, the difficulties we had and how we resolved them