Epiphrenic esophageal diverticulum after laparoscopic placement of an adjustable gastric band

A morbidly obese woman (BMI 56 kg/m2) in 1998 underwent laparoscopic placement of an adjustable gastric band by the perigastric approach. 5 years later, she complained of reflux and weight regain. X-ray with contrast revealed pouch dilatation. She subsequently underwent a laparoscopic revision including retrocardia band replacement using the pars flaccida technique. During the further course, an epiphrenic diverticulum was diagnosed. Because of danger of perforation of the large thin-walled diverticulum and the esophageal motility disorder, the band was laparoscopically removed and the diverticulum was resected via a transhiatal approach. This case presents a very rare complication after placement of a gastric band and its successful management.