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DOI: 10.1055/a-2109-0991
An airbag cap specially designed for the removal of sharp, deeply embedded foreign bodies: a new method of cap-assisted endoscopy
Removal of esophageal foreign bodies is a common emergency endoscopic treatment [1]. However, large foreign bodies and sharp edges are extremely risky and difficult to remove endoscopically, and affected patients often undergo surgical operations, which greatly increases the damage to the body [2]. We have developed an endoscopic anterior cap with an airbag specifically for the removal of these difficult foreign bodies ([Fig. 1]), with excellent results.
A 61-year-old man had retrosternal pain after eating fish. Computed tomography showed a foreign body in the upper esophagus, 14 × 4 mm in size, which was embedded in the esophageal wall, adjacent to the left subclavian artery ([Fig. 2]). As the foreign body was large, sharp, deeply embedded, and close to a blood vessel, it could not be removed by conventional endoscopic procedures, even with a transparent cap. We replaced the anterior cap with an airbag, entered the esophagus near the foreign body, inflated the airbag with about 20 mL of gas, and the expanded airbag effectively supported the esophageal wall and improved the operating space ([Fig. 3]). We used foreign body forceps to lift the foreign body away from the esophageal wall, adjusted the orientation, and collected the foreign body into the anterior cap ([Fig. 4]). After extracting the gas from the airbag, the foreign body was successfully removed ([Fig. 5]). On examination, only mild mucosal lesions were present.
The use of the airbag cap is shown in the video ([Video 1]). A syringe is used to inflate the airbag, which can be expanded into a ring balloon with a maximum diameter of 3 cm, and the inflation amount is adjusted according to the needs of the operation. This method can effectively support the esophageal wall, improve the operating space, shorten the endoscopic surgery time, and reduce damage to the digestive tract. Further studies with large sample sizes are required to evaluate the safety and effectiveness of the airbag cap.
Video 1 An airbag cap specially designed for the removal of sharp, deeply embedded foreign bodies.
Qualität:
Endoscopy_UCTN_Code_TTT_1AO_2AL
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).
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Publikationsverlauf
Artikel online veröffentlicht:
13. Juli 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Ikenberry SO, Jue TL, Anderson MA. et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73: 1085-1091
- 2 Geng C, Li X, Luo R. et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study of 1294 cases. Scand J Gastroenterol 2017; 52: 1286-1291