Laparoscopic Removal of a Displaced Vertical Gastric Clip Causing Gastric Outlet Obstruction

Introduction Recently, some surgical teams have used a laparoscopic vertical clip gastroplasty to treat morbid obesity. This approach mimics the principle of laparoscopic sleeve gastrectomy, but using a completely reversible mechanism. Displacement of the device has been reported in 7.7% of cases. The manner of its withdrawal has not been described to date. Methods A 50-year-old woman with a body mass index (BMI) of 36.3 kg/$ m^{2} $ underwent a laparoscopic calibrated tubular gastroplasty at another hospital with an 38-F orogastric tube by a B-CLAMP® gastric clip on January 11, 2019. The patient came to the Emergency Department 8 months later due to complete oral intolerance, with continuous vomiting of 5 days of evolution. Physical examination: BMI 28.9 kg/$ m^{2} $, dehydration; depressed abdomen, with mainly supraumbilical pain and distension, and significant tympanism on palpation. No guarding or signs of peritoneal irritation. Simple abdominal x-ray showed gastric distension and gastric clip. The nasogastric tube drained 2500 cc of gastrobiliary contents. The computed tomography showed the gastric clip displaced and located medially to the esophagogastric junction, the lesser curvature, and the antropyloric region. Results A laparoscopic approach was performed using 4 trocars. Signs of gastric suffering in the antral region. The clip was located to the right of the lesser curvature covered by a layer of fibrosis. The clip was removed by a 12-mm trocar. There were no postoperative complications. Conclusion This video demonstrates a form to extract a displaced gastric clip used to create a calibrated tubular gastroplasty using a laparoscopic approach..

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Obesity surgery - 30(2020), 7 vom: Juli, Seite 2856-2857

Sprache:

Englisch

Beteiligte Personen:

de la Plaza Llamas, Roberto [VerfasserIn]
Díaz Candelas, Daniel A. [VerfasserIn]
Ramia, José M. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

B-CLAMP®
Gastric clip
Gastric sleeve
Laparoscopic vertical clip gastroplasty
Reversible bariatric surgery

Anmerkungen:

© Springer Science+Business Media, LLC, part of Springer Nature 2020

doi:

10.1007/s11695-020-04606-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2117836607

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