43194 Esophagoscopy, rigid, transoral; with removal of foreign body(s)

Name of the Procedure:

Esophagoscopy, rigid, transoral; with removal of foreign body(s)

Summary

In this procedure, a rigid tube called an esophagoscope is inserted through the mouth and into the esophagus to locate and remove foreign objects. It's a direct and effective way to address issues caused by swallowed items.

Purpose

This procedure is used to address obstructions in the esophagus due to swallowed foreign bodies. The goal is to safely remove the object(s) and restore normal esophageal function without causing damage to the esophagus.

Indications

• Swallowed foreign objects (e.g., food, coins, toys)
• Difficulty swallowing
• Pain in the chest or throat
• Signs of infection or abscess due to a foreign body

Preparation

• Fasting for at least 6-8 hours prior to the procedure
• Adjustments or temporary discontinuation of certain medications (e.g., blood thinners)
• Pre-procedure imaging (e.g., X-rays, CT scan) to locate the foreign body
• An evaluation of the patient’s overall health and medical history

Procedure Description

1. The patient is positioned and given anesthesia, usually general, to ensure they are unconscious and pain-free.
2. A rigid esophagoscope is carefully inserted through the mouth and passed down the esophagus.
3. Visualization is achieved using a camera on the esophagoscope, allowing the surgeon to locate the foreign body.
4. Special tools are introduced through the esophagoscope to grasp and remove the foreign body.
5. The esophagus is inspected for any residual damage or complications.
6. The esophagoscope is withdrawn slowly and the patient is moved to recovery.

Duration

The procedure typically takes 30 to 60 minutes, depending on the complexity of the removal.

Setting

This procedure is typically performed in a hospital operating room or specialized outpatient surgical center.

Personnel

• Otolaryngologist (ENT specialist) or gastroenterologist
• Anesthesiologist
• Surgical nurse
• Possible support staff, depending on the setting

Risks and Complications

• Perforation or injury to the esophagus
• Bleeding
• Infection
• Adverse reactions to anesthesia
• Aspiration pneumonia

Benefits

• Prompt removal of the foreign object
• Relief of symptoms such as pain and difficulty swallowing
• Prevention of potential complications like infection and esophageal damage

Recovery

• Monitoring in a recovery area until the effects of anesthesia wear off
• Possible short-term sore throat or minor discomfort
• Instructions for a soft or liquid diet for 24-48 hours post-procedure
• Follow-up appointments to monitor healing and ensure no complications

Alternatives

• Flexible endoscopy: Less invasive but may not be suitable for all types of foreign bodies.
• Wait-and-see approach: Appropriate if the object is likely to pass naturally without causing harm.
• Surgery: Reserved for cases where endoscopic removal is not possible or safe.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not experience pain. Afterward, minor discomfort or a sore throat is common. Pain management, such as analgesics, is typically provided to ensure comfort during recovery.