Erosion is a well documented complication of laparoscopic adjustable banding. Our video demonstrates a technique of endoscopic band removal with a single transgastric trocar placed for laparoscopic assistance.

A 66 year old female who had an adjustable gastric band placed in Mexico in 2002 presented with diarrhea and vague abdominal pain. Endoscopy showed band erosion with 75% of the band exposed intraluminally. The operative plan was endoscopic removal of the band with placement of a laparoscopic transgastric 5 mm trocar for cutting and mannual removal of the band into the gastric lumen. Once the band tubing is cut, the gastric band was grasped by the endoscope and removed transorally. The 5 mm gastrotomy was closed with an interupted suture.

The operative time was 85 minutes. The patient was discharged home on post operative day one. Postoperative complication included a subcutaneous wound infection at the site of the port removal. At two months follow up, the patient was doing well with no significant complaints.

Complete endoscopic removal of eroded gastric banding have been described but only for cases with the majority of the band exposed intraluminally. Our case demonstrates the feasibility of endoscopic removal of partially eroded gastric banding with laparoscopic assistance with a single 5 mm trocar placed transgastrically.