Poster Presentation ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017

Retained foreign body after surgical removal of adjustable gastric band (#237)

Daniel Cattanach 1 , Benjamin Teague 2
  1. General Surgery, Hervey Bay Hospital, Urraween, QLD, Australia
  2. Surgiscope SA, Ashford, SA, Australia

Laparoscopic adjustable gastric band is associated with significant weight loss and comorbidity resolution. There is however, a high re-operation rate when compared to other obesity surgeries. Removal of adjustable gastric band is an increasingly common bariatric procedure. This leads to a risk of potential complications including retained foreign body. We present a case series of four cases of retained foreign body after  surgical removal of a gastric band. Three cases of unrecognised retained foreign body complicating surgical removal of gastric band and one case of recognised retained foreign body complicating endoscopic removal of gastric band were identified in a metropolitan Australian obesity surgery practice. These cases were analysed to determine circumstances and similarities leading to retained foreign body. Retention of band tubing was often associated with unexplained postoperative abdominal pain although some cases were asymptomatic. Three of four cases involved difficult surgery, or surgery associated with intra-operative complications and it is postulated that this may lead to increased risk of retained foreign body from gastric band. While radiological imaging demonstrated the foreign body in all cases, imaging was often misleadingly and incorrectly interpreted by radiologists. In patients post removal of gastric band devices who present with atypical or persistent postoperative pain, particularly localised pain, a review of radiological imaging by the surgeon is essential. Furthermore, strategies at preventing this complication should be implemented. Specifically, removal technique, device familiarisation and post removal inspection all play a role.