Background: Laparoscopic adjustable gastric band (LAGB) is a common and an effective bariatric procedure. It involves the placement of an adjustable band with an inflatable balloon at the gastric cardia near the gastroesophageal junction. However, several complications have been reported. These include port-site infections, slippage of the band, and band erosion.

Case summary: A 44 years-old female who was found to have an eroding gastric banding during esophagogastroduodenoscopy incidentally. The gastric band was placed laparoscopically five years prior to presentation. The band was removed successfully through an endoscopic laparoscopic-assisted technique under general anesthesia. Starting endoscopically, the eroded gastric band was visualized and then broken using a mechanical lithotripter. However, a small portion of the band remained embedded in the mucosa and prevented the retrieval. Simultaneously, laparoscopy revealed intraabdominal adhesions which were released, freeing the gastric band into the stomach and allowing extraction of the gastric band using a snare was completed endoscopically while ensuring examination of intact gastric mucosa. The post-operative course and follow up were uneventful.

Conclusion: Eroded LAGB can be silent necessitating life-long follow-up. Endoscopic laparoscopic-assisted approach allows definitive management, examining gastric wall integrity and leaks simultaneously.