Laser-guided rescue: endoscopic removal of complex esophageal foreign bodies

Laser-guided rescue: endoscopic removal of complex esophageal foreign bodies About 10 %-20 % of esophageal foreign bodies require intervention [1].Dentures are particularly difficult to remove due to their size, sharp edges, and metal parts [2].While endoscopy is often effective, some cases need surgery [3].We report two cases of successful laser-assisted removal of impacted foreign bodies.Case 1.A 35-year-old man with alcohol use disorder accidentally swallowed his denture.After failed removal attempts elsewhere, he was referred to our center.Computed tomography (CT) showed a radiopaque object at the D3 level ( Fig. 1).Endoscopy confirmed an impacted three-tooth denture with a sharp metallic edge, deeply embedded in the esophageal wall, with a contained perforation.Given the failure of convention-al techniques, the patient was intubated and endoscopy-guided laser lithotripsy was used for fragmentation. Fig. 1 Computed tomography images.a-c A well-defined curvilinear radiopaque density measuring 3.2 6.2 cm was noted in the upper thoracic esophagus at the level of the D3 vertebral body with associated short segment circumferential wall thickening (9 mm). Fig. 2 Laser fiber (LightTrail Reusable 365 m; Boston Scientific, Galway, Ireland) was preloaded onto a catheter (One Action Stent Introduction System [OASIS] internal catheter, 6 Fr, 203 cm; Cook Medical, Bloomington, Indiana, USA). Fig. 3 Case 1. a Laser-guided fragmentation of the denture.b Sectioning of the metallic wire.c Denture after complete fragmentation.d Retrieved denture fragments after removal.