Successful laparoscopic removal of a migrated Angelchik prosthesis

Implantation of an Angelchik prosthesis has been considered a quick and safe procedure for the surgical treatment of gastroesophageal reflux disease. Since its introduction in 1979 more than 25,000 have been inserted worldwide. However, the use of this device has been largely abandoned because of frequent complications and high costs. One of the more serious complications is migration of the prosthesis, which usually requires open correction. We recently operated on a 49-year-old man with a migrated Angelchik prosthesis. The device, placed 17 years earlier, had now migrated to the free abdominal cavity causing recurrent urinary tract infections and fecal incontinence. The prosthesis was removed laparoscopically via three ports in a simple procedure without any blood loss. Recovery was uneventful. At this writing, complaints have resolved, and reflux is being controlled medically. This case supports the suggestion that Angelchik prosthesis-related problems may be solved laparoscopically, even if the device was inserted via an open procedure.