Endoscopy 2019; 51(09): E251-E252
DOI: 10.1055/a-0889-7476
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© Georg Thieme Verlag KG Stuttgart · New York

Use of the novel BougieCap in the treatment of esophageal peptic stricture

João Cortez-Pinto
Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE, Lisboa, Portugal
,
Susana Mão de Ferro
Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE, Lisboa, Portugal
,
António Dias Pereira
Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE, Lisboa, Portugal
› Author Affiliations
Further Information

Corresponding author

João Cortez-Pinto, MD
Gastroenterology Department
Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE
1099-023 Lisboa
Portugal   
Fax: +00351-91-9071329   

Publication History

Publication Date:
09 May 2019 (online)

 

Various methods are available for the endoscopic treatment of benign strictures in the upper gastrointestinal tract. The most common is the sequential use of Savary-Gillard bougies after passing a guidewire through the stricture [1]. The main problem with this method is the lack of direct visual control of the bougienage procedure [2]. BougieCaps (Ovesco Endoscopy AG, Tübingen, Germany) are single-use caps of different sizes that can be attached to an endoscope. Bougienage is carried out by advancing the endoscope through the stenosis while allowing good visualization of the surrounding tissue [3].

Our aim was to present our first experience of stricture dilation with the BougieCap. We selected a 58-year-old man with a peptic stricture who had already undergone multiple dilations, with persistent dysphagia.

Our patient presented an esophageal stricture with an estimated luminal diameter of 4 mm that could not be passed with a 5.4 mm gastroscope. The 8 mm BougieCap was attached to the 5.4 mm gastroscope tip ([Fig. 1]) and placed proximally to the stricture. A nitinol guidewire was advanced through the cap and past the stricture. Bougienage was accomplished by advancing the scope through the stricture using gentle rotation movements. The procedure was sequentially repeated with a 10 mm BougieCap (5.4 mm gastroscope) and then a 12 mm BougieCap (9.2 mm gastroscope) ([Video 1]). Inspection without the BougieCap was done at the end of the procedure. Completion of the procedure with a 14 mm and 16 mm BougieCap was scheduled 3 weeks later; however, a 5 mm stricture was recognized and the previous sequence was repeated (8, 10, and 12 mm BougieCaps).

Zoom Image
Fig. 1 The 8 mm BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) was attached to the 5.4 mm gastroscope tip.

Video 1 BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) dilation in a refractory peptic stricture.


Quality:

There were no immediate or delayed complications in either procedure. The procedure time was 31 minutes in the first session and 16 minutes in the final session.

BougieCap is a safe and easy new therapeutic method for dilation of esophageal benign strictures under direct visualization.

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Competing interests

None


Corresponding author

João Cortez-Pinto, MD
Gastroenterology Department
Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE
1099-023 Lisboa
Portugal   
Fax: +00351-91-9071329   


Zoom Image
Fig. 1 The 8 mm BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) was attached to the 5.4 mm gastroscope tip.