Combined laparo-endoscopic management of an eroded gastric band: a rare case report

Introduction and importance: Obesity remains a major global health challenge, and bariatric surgery is an effective intervention for severe cases. Once popular, use of laparoscopic adjustable banding has declined due to long-term complications, including band erosion. While endoscopic techniques are increasingly used, complex cases may require a combined laparo-endoscopic approach. This case demonstrates the value of such a hybrid technique in managing advanced band erosion. Presentation of case: A 62-year-old male presented with a 7-day history of vomiting and dysphagia to solids. Clinical examination was stable aside from signs of dehydration. Initial differential included band slippage, gastric outlet obstruction, and band erosion. Computed tomography scan and gastroscopy revealed significant band erosion with partial obstruction of the gastroesophageal junction. A laparo-endoscopic approach was utilized to divide and retrieve the eroded band and tubing, followed by repair of the gastric defect with minimal trauma. The patient’s recovery was uneventful, and he was discharged in stable condition. At 1-month follow-up, he remained symptom-free. Clinical discussion: The presented case supports growing evidence of the advantages of a hybrid laparo-endoscopic approach in treating complex band erosion. This technique offers clear visualization, complete division and retrieval of the band and its tubing, and reduced risk of gastric perforation. Given the rarity of these cases and the lack of consensus on the optimal technique, this case adds to the limited evidence supporting individualized, minimally invasive strategies. Conclusion: A combined laparo-endoscopic technique is a safe and effective option for managing severe gastric band erosion, especially when endoscopic removal alone is insufficient. This approach reinforces the importance of tailoring intervention strategies to the complexity of each case.