# Combined endoscopic and laparoscopic management of mesh erosion following vertical banded gastroplasty: a case report and literature review

## TL;DR

A patient with a rare complication from an old weight-loss surgery was successfully treated using a combination of endoscopic and surgical methods.

## Contribution

This case report presents a novel combined endoscopic and laparoscopic approach to manage mesh erosion after vertical banded gastroplasty.

## Key findings

- Endoscopic removal of the eroded polypropylene mesh was successful without complications.
- Staged laparoscopic revisional surgery resolved persistent symptoms and improved weight control.
- The combined approach achieved sustained symptom resolution and weight management over 18 months.

## Abstract

Vertical banded gastroplasty (VBG) has largely been abandoned due to late complications, including the rare but serious erosion of prosthetic mesh into the gastric lumen. We report the case of a 46-year-old woman who developed progressive epigastric pain, vomiting, and weight regain two decades after VBG. Endoscopic and radiologic evaluations revealed intragastric erosion of a polypropylene mesh, which was successfully removed endoscopically without complication. Persistent symptoms and inadequate weight control, attributed to altered gastric anatomy, necessitated staged revisional surgery. The patient subsequently underwent laparoscopic sleeve gastrectomy followed by single-anastomosis sleeve–ileal bypass, achieving sustained symptom resolution and satisfactory weight control over an 18-month follow-up period. This case supports a combined endoscopic and surgical approach for managing complex sequelae of VBG.