Commentary

Stents are commonly used to treat benign esophageal strictures or perforations, and migration is one of the major adverse events following placement. Stent characteristics known to reduce migration include a flared stent design and a large stent size. Nevertheless, migration still occurs in 10 % – 15 %, especially when the stricture is short with a small diameter or even not present in the case of spontaneous perforation.

Recently reported methods for prevention of stent migration include, among others, endoscopic suturing and a dedicated stent fixation clip device (“stentfix OTSC”); however, these methods are not available in all countries and are expensive.

This E-Video demonstrates another technique: after submucosal injection, a 1-cm vertical mucosal incision is made above the upper end of the stent, at the 12 o’clock position, after which the stent is fixed to the esophageal wall in the distal part of the incision with a hemoclip; the process is repeated at the 6 o’clock position. Although this technique can be performed with universally available equipment, it remains to be established whether it can reduce stent migration in patients with an increased risk of this event.

Publication History

Article published online:
27 October 2020