Clip slippage and gastric perforation following BariClip vertical gastroplasty: a case report.

BariClip gastroplasty is an emerging bariatric technique designed to preserve gastric anatomy while providing restrictive weight loss. While preliminary reports have shown promising outcomes, the variety of complications remains incompletely defined. We report the case of a woman in her late 40s with BMI > 35 and a medical history of hypothyroidism, who underwent elective BariClip placement as a primary bariatric intervention. On the second postoperative day, she presented with abdominal discomfort, nausea, and distention. A computed tomography scan revealed inferior slippage of the BariClip and esophageal hematoma. Diagnostic laparoscopy confirmed migration of the device with associated multiple perforations along the gastric wall. The clip was removed, and the perforations were repaired by primary suturing. On the first postoperative day of the secondary operation, the patient developed acute dyspnea and was diagnosed with pulmonary embolism, treated with therapeutic anticoagulation, and discharged home in good condition on postoperative Day 10.