Retrieval of a large rubber tube from the stomach by a loop technique

Abstract

pin to the midpoint. The loop was then closed slowly until the free ends of the pin were approximated. Reopening the snare loop permitted the sharp point to be secured within the safety catch. The snare was withdrawn, the grasping forceps was inserted, and the closed pin was secured at the spring end. Once the pin was pulled close to the tip of the endoscope, the entire apparatus was removed. The endoscope was reinserted a final time, and no residual mucosal injury was noted in the stomach or esophagus. The patient's subsequent course was uncomplicated. DISCUSSION To assess the reproducibility of this procedure, the following experiment was performed. Several open safety pins of varying sizes (3.5, 5.0, 6.0 cm) were immersed in gastric juice to approximate intragastric conditions and snared in the manner described above. In almost every instance, the pin, once completely closed by the snare so that the point was past the safety catch, snapped shut as the snare wire slackened (Figure I). The failures occurred with a semicircular polypectomy snare (Olympus SD-1 U) that had been used many times and which was not capable of generating the tension necessary to close the large pin. With the crescent shaped snare