PMC5847317_01
Endoscopic images showing: a the esophageal covered metal stent with its distal edge protruding into the stomach wall (retrograde view); b the esophageal covered metal stent being trimmed using argon plasma coagulation in retroflexed view.
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F1
However, 1 month after stent placement, she developed epigastric pain and dysphagia from impaction of the stent into the proximal stomach (Fig.1a). The distal portion of the stent was trimmed with APC using a generator at a setting of 80W and a flow rate of 2L/min (Fig.1b; Video 1).
The transected portion of the covered metal stent.
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F2
A length of the stent (approximately 4cm) was completely severed in a circumferential manner and was successfully removed from the stomach (Fig.2).
The remainder of the covered metal stent following its complete removal 3 months later.
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F3
The distal part of the stent was then grabbed with a rat-toothed forceps, and the endoscope was withdrawn in a steady rotational fashion, such that the mesh eventually inverted, was dislodged, and then was successfully removed en bloc (Fig.3; Video 2).
Esophagogram showing a patent esophagus with no extravasation of contrast.
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F4
A subsequent esophagogram demonstrated improvement of the stricture without evidence of contrast extravasation (Fig.4).