Modified technique to extract malpositioned or migrated self-expanding stents from the esophagus and stomach.
OBJECTIVE
Various methods have been used to remove self expandable stents (SES) because of either malposition or migration. The main difficulties encountered in such situations are the anatomic obstacle of the lower and upper esophageal sphincters as well as risk of mucosal injury during removal.


METHODS
We describe a modified approach using an esophagogastroduodenoscope (EGD) in combination with a foreign body hood protector, rat tooth forceps and snare allowing for successful SES removal from the upper gastrointestinal tract in four cases.


RESULTS
In all cases, the SES were successfully removed from upper gastrointestinal tract using this technique. No complications were noted after extraction.


CONCLUSIONS
The foreign body hood protector combined with rat tooth forceps/snare technique is a safe and effective alternative to previously described methods for extraction of SES from the upper gastrointestinal tract. This method may be applicable for the removal of other such objects within the endoscope's reach.
Munoz
Juan Carlos
JC
Division of Gastroenterology, University of Florida Health Science Center/Jacksonville, Jacksonville, Florida 32207, USA.
Khoury
Joe E
JE
Alizadeh
Mary
M
Pudhota
Sunitha
S
Smith-McCutchen
Aja
A
Corregidor
Ana M
AM
Lambiase
Louis R
LR
Vega
Kenneth J
KJ
D000328:Adult; D000368:Aged; D002404:Catheterization; D020878:Device Removal; D004867:Equipment Design; D020701:Esophagoscopes; D004945:Esophagoscopy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D013270:Stomach / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome