Words of Caution Regarding Adjustable Gastric Band Tubing
Christopher Starnes, MD, Sheilendra S. Mehta, MD, Peter A. Walker, MD, Kulvinder S. Bajwa, MD, Erik B. Wilson, MD, Shinil K. Shah, DO
Department of Surgery, University of Texas Medical School, Houston, TX (all authors). Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX (Dr Shah).
Introduction: With the decreasing popularity of adjustable gastric band (AGB) placement and the increase in explants of the devices, for erosion, slips, or inadequate weight loss, in performing revisional surgery, it is of vital importance for surgeons to understand the problems that may arise during removal. This case involved an uncommonly reported complication of fractured band tubing resulting in incomplete removal of the tubing during revisional bariatric surgery, with reoperation necessary for complete removal. In the course of the procedure, a small-bowel tumor was identified.
Case Description: We present a 35-year-old woman who underwent conversion of a laparoscopic AGB to a sleeve gastrectomy. Failure to recognize a fracture in the band tubing resulted in retained tubing and readmission secondary to abdominal pain. During reoperation to remove the retained tubing, a small-bowel gastrointestinal stromal tumor (GIST) was incidentally identified and resected.
Discussion: This case highlights a rarely reported complication of fractured gastric band tubing, resulting in incomplete removal of the tubing during revisional surgery, with the incidental discovery of a GIST in the small bowel.
Key Words: Adjustable gastric band, Gastrointestinal stromal tumor, Re-operative surgery, Revisional bariatric surgery.