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Novel use of an endoscopic suturing device for rectal foreign body retrieval
1Institute for Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, Maryland, USA.
Background And Aims:
Endoscopic removal of gastrointestinal tract foreign bodies could be difficult when the foreign body significantly exceeds the size of the available endoscopic extraction devices (snares, nets, etc). We present successful use of an endoscopic suturing device for retrieval of a large rectal foreign body not amenable to retrieval by traditional endoscopic extraction devices.
Methods:
The patient was a 45-year-old biological male transitioning to female who presented to the emergency department with a self-reported 8-inch rectal foreign body. Extraction with the patient under anesthesia was unsuccessful, and to avoid surgery, a flexible sigmoidoscopy was attempted.
Results:
Attempts to remove the rectal foreign body using traditional retrieval devices were unsuccessful because of a large diameter and very slippery surface of the silicone sex toy. After 11 minutes of unsuccessful attempts, we inserted the OverStitch endoscopic suturing device (Boston Scientific, Marlborough, Mass, USA) into the rectum. We pierced the suturing arm of the device through the foreign body and were able to retrieve it from the rectum in 5 minutes.
Conclusions:
This case demonstrates unexpected value of an endoscopic suturing device for endoscopic removal of a large foreign body not amenable to extraction with traditional dedicated endoscopic devices. Use of an endoscopic suturing device enabled successful removal of the difficult foreign body and eliminated the need for urgent surgery.
