Saving private scope, an emergency technique to remove a stuck EGD from the esophagus by using another EGD. The removal of migrated esophageal stents could be achieved by using a variety of accessory tools. This includes the use of rat tooth grasping forceps, alligator jaw grasping forceps, snares, or baskets. However, the malfunction of these tools is rare and not usually reported in the literature. Our case is a 58-year-old male with a history of a refractory esophageal stricture, 40 cm from the incisors and measuring around 7 mm in diameter and less than 1 cm in length. The patient had an EGD with a placement of a fully covered metal stent, and the stent was anchored to the esophagus with an over-the-scope clip. However, the case was complicated by stent migration to the stomach. The patient underwent an EGD for a stent removal. We used an alligator jaw grasping forceps to remove the stent. The forceps was attached to the stent removal string. During the procedure, the stent was stuck in the upper esophagus, and the removal of the stent was not successful. We also noted that the alligator forceps was jammed inside the accessory channel, while the other end was attached to the stent removal strings. Attempts to advance or pull the alligator forceps from the accessory channel were not successful, and attempts to open or close the alligator forceps were not successful as well. We used another EGD scope to help free the stuck EGD scope. We can see in the upper part of the screen, the stuck EGD scope was a trapped alligator forceps grasping the two removal strings. The alligator forceps was attached to two removal strings. We identified the first removal string and started to target it by using a high-energy ABC to try to break it down. As we can see, we used the thermal effect of ABC to heat up the string wires and attempt to break it. Then we started to introduce an endoscopic scissor to cut the heated strings. We then moved on to the second removal string and repeated the process again by using the high-energy APC probe and endoscopic scissors to break the wire. After successfully breaking the stent wires, we were able to remove the stuck EGD from the esophagus, and then we were also able to remove the trapped alligator forceps from the tip of the scope. In conclusion, the use of a high-energy APC probe and endoscopic scissors can be successful in cutting stent wires. This could prove valuable in situations where the EGD scope is stuck while removing the stent and there is a malfunction of accessory tools. APC and endoscopic scissors are readily available in the GI lab and their use allowed our patients to avoid the more complicated surgical approach.

refractory esophageal stricture

EGD procedure

stent removal

alligator jaw grasping forceps

high-energy ABC probe