Laparoscopic Transgastric Removal of an Eroded Angelchik Prosthesis

Abstract

The Angelchik prosthesis is a silicone gel-filled implant historically placed around the gastroesophageal junction for the treatment of gastroesophageal reflux disease. Herein, we describe the laparoscopic transgastric removal of an Angelchik prosthesis that had eroded through the gastroesophageal junction of a patient 25 years after its placement. Under direct laparoscopic and endoscopic guidance, laparoscopic trocars were placed transabdominally, directly into the gastric lumen. Using 2-mm instrumentation, the prosthesis was transected, endoscopically snared, and removed perorally. The patient was discharged after a 3-day hospital stay. This is the first published description of a laparoscopic, transgastric approach to removal of a partially eroded prosthetic device to the stomach.