A new endoscopic technique for the removal of gastric phytobezoars

Background: There is no standardized method for the evacuation of gastric p hytobezoars. Prior endoscopic attempts have used injected cellulase and var ious devices to disrupt bezoars. The efficacy of directed, large-channel su ction using an endoscope for the removal of large gastric phytobezoars is t he subject of this study. Methods: Three consecutive patients with large gastric bezoars were examine d. Phytobezoar removal using a standard endoscope (GIF-100, Olympus) was at tempted but unsuccessful. Each phytobezoar was successfully evacuated by di rected suction through an endoscope with a large-diameter accessory channel (GIF-XT30, Olympus), Each patient was followed up for bezoar recurrence, Results: Rapid, complete bezoar evacuation was achieved at one session in a ll patients. Aspirated volumes were 500, 700, and 1000 mL. There were no pr ocedure-related complications. Conclusions: Endoscopic suction removal of gastric phytobezoars using a lar ge-channel endoscope is efficacious and safe. Coupling directed endoscopic suction with other endoscopic techniques might be efficacious for removal o f more complex bezoars.