Volume 4, Issue 8, Pages (August 2019)

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Volume 4, Issue 8, Pages 366-368 (August 2019) Minimally invasive endoscopic management of buried bumper syndrome by use of a novel dedicated resection device Deborah Costa, MD, Edward J. Despott, MD, FRCP, FEBGH, FASGE, Nikolaos Lazaridis, MD, PhD, Nikolaos Koukias, MD, Alberto Murino, MD VideoGIE Volume 4, Issue 8, Pages 366-368 (August 2019) DOI: 10.1016/j.vgie.2019.04.007 Copyright © 2019 Terms and Conditions

Figure 1 Buried bumper at CT. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 2 Buried bumper appearance at EGD, located in the proximal anterior wall of the gastric antrum. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 3 The Flamingo set containing the Flamingo device, a 35-gauge guidewire (6/10 mm), and a foreign body removal forceps. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 4 Intragastric passage of a 35-gauge guidewire, pushed through the cutaneous aspect of the PEG tract. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 5 External manipulation of the Flamingo device. The assistant externally controls the Flamingo device with 2 hands. One hand regulates the flexion of the cutting wire through the handle, and the other hand manipulates the shield of the Flamingo device regulating the push-and-pull movements and the rotation movements. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 6 Flamingo device with its cutting wire, flexed by 180°. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 7 Initial exposure of the PEG plastic bumper. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 8 Release of the PEG bumper into the gastric lumen. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions

Figure 9 Remnant PEG tube and bumper retrieved by use of grasping forceps. VideoGIE 2019 4, 366-368DOI: (10.1016/j.vgie.2019.04.007) Copyright © 2019 Terms and Conditions