Background

For patients with failed weight loss after a Roux-en-Y gastric bypass, the application of an adjustable gastric band over the gastric pouch, referred to as 'salvage banding', has been demonstrated in small series. Band erosion following adjustable gastric band procedures is a known complication which occurs in less than 5% of cases when performed in patients with normal anatomy. Less is known regarding complication rates following salvage banding procedures. A systematic review published in 2012 identified a 2% incidence of band erosion after salvage banding. However, a review of the literature found no studies specifically describing the management or outcomes of patients with band erosion after salvage banding procedures. This video describes a case example of one such patient, including video of the endoscopic management of band erosion and the resultant jejunocutaneous and gastrogastric fistulae. A discussion regarding the cautious use of endoscopic management in these cases is included.