Entanglement of an over-the-scope full-thickness endoscopic suturing device during stent fixation: a case series of adverse events and rescue strategies.
Publication/Presentation Date
1-1-2026
Abstract
BACKGROUND AND AIMS: Esophageal fully covered self-expandable metal stents (FCSEMSs) and lumen-apposing metal stents are used for the management of strictures and luminal defects. Stent fixation can minimize stent migration risk, and endoscopic suturing is an effective option. Here, we describe an adverse event of over-the-scope endoscopic suturing device entanglement during stent fixation and discuss rescue maneuvers.
METHODS: Three experienced advanced endoscopists performed 5 cases of stent fixation with an over-the-scope endoscopic suturing device.
RESULTS: Esophageal through-the-scope FCSEMSs were placed in 3 patients; all had previous radiation. During stent fixation, the needle driver was caught on the stent, out of the field of view. An argon plasma coagulator with a second endoscope inserted adjacently was used to free the stent in 2 cases; in the third case, forceful handle separation with the device outside the patient facilitated stent release. In 2 gastric cases, stents (FCSEMSs and lumen-apposing metal stents) in the stomach were disentangled using rat-tooth forceps.
CONCLUSIONS: Over-the-scope suturing device entanglement with FCSEMSs is possible and can occur outside the field of view. Reduced esophageal wall compliance caused by radiation and the use of more-flexible through-the-scope stents may have contributed to this adverse event. Rescue maneuvers for entanglement include argon plasma coagulation of the stent wire, rat-tooth forceps, and forceful handle separation.
Volume
11
Issue
1
First Page
31
Last Page
34
ISSN
2468-4481
Published In/Presented At
Duffey, K., Kamal, F., Loren, D., & Kumar, A. (2025). Entanglement of an over-the-scope full-thickness endoscopic suturing device during stent fixation: a case series of adverse events and rescue strategies. VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 11(1), 31–34. https://doi.org/10.1016/j.vgie.2025.08.011
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41584628
Department(s)
Administration and Leadership
Document Type
Article