Atlas of Gastroenterological Endoscopy
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Rubber band ligature (banding)
Rubber band ligature Rubber band ligature Rubber band ligature
Placing elastic O-ring ligatures is an alternative way to treat bleeding varices. The procedure is shown in the 3 following pictures. To the left the spurting varix is drawn into the sleeve of the banding device ( Six-ShooterŪ ), thereafter the banding is performed by application of the elastic O-ring. (Middle). Multiple (up to six) rings can be deployed from the device onto the varices by means of release strings without retraction and reintubation of the endoscope. The right picture shows the strangulated varix after ligature.
Immediatly after rubber band ligature 1 day after rubber band ligature Rubber band ligature at the cardia
These 3 photos represent the pathological changes occurring after ligation. The shows the varice just after ligation, whereas the photo in the middle was taken 1 day after ligation at the instance of an emergency second look gastroscopy. The rubber band has already fallen off, leaving behind an oozing ulcer. Further endoscopic therapy is mandatory and implemented by applying another rubberband at amore distal location. The shows a ligated cardial varice as shown by inversion of the endoscope in the stomach.
Rubber band ligature- rubber band Rubberband found in the stomach after unsuccessful deployment onto a esophageal varice.