title: Modified technique to extract malpositioned or migrated self-expanding stents from the esophagus and stomach.
abstract: 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.
authors.affiliation: Division of Gastroenterology, University of Florida Health Science Center/Jacksonville, Jacksonville, Florida 32207, USA.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Munoz
authors.forename: Joe E
authors.initials: JE
authors.lastname: Khoury
authors.forename: Mary
authors.initials: M
authors.lastname: Alizadeh
authors.forename: Sunitha
authors.initials: S
authors.lastname: Pudhota
authors.forename: Aja
authors.initials: A
authors.lastname: Smith-McCutchen
authors.forename: Ana M
authors.initials: AM
authors.lastname: Corregidor
authors.forename: Louis R
authors.initials: LR
authors.lastname: Lambiase
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Vega
mesh_terms: 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