Endoscopic management of buried bumper syndrome in children using a dedicated endoscopic resection device (Flamingo): A single‐centre retrospective case series

Buried bumper syndrome (BBS) is a serious complication of percutaneous endoscopic gastrostomy (PEG) tubes. Management of completely buried bumpers is challenging, as surgical approaches carry significant morbidity and endoscopic techniques can be technically demanding. A dedicated endoscopic resection device (Flamingo) is a tool designed to facilitate controlled incision and exposure of the buried bumper, but its use in paediatric patients has not previously been reported. We performed a single-centre retrospective review of paediatric patients with BBS treated using this device. Nine patients aged 2-16 years with a median American Society of Anesthesiologists Grade 3 were identified. Successful bumper removal was achieved in all cases, with a mean procedure time of 46.1 min. One recurrence was successfully retreated, and one readmission occurred due to jejunostomy tube displacement. No procedure-related complications were observed. These findings suggest the device is a safe and effective minimally invasive treatment for paediatric BBS.