Modern endoscopist’s toolbox: Innovations in foreign body removal

Abstract

Foreign body ingestion is a common gastrointestinal emergency, particularly in children, who account for 80% of cases. While most ingested objects pass spontaneously, around 20% require medical intervention. In adults, incidents often occur accidentally during meals, leading to impactions, especially in individuals with underlying esophageal conditions. Endoscopy remains the gold standard for foreign body retrieval, with a success rate exceeding 95%. The type, shape, and location of the foreign body determine the clinical presentation and management approach. Sharp objects, batteries, and large items pose the highest risk of complications, including perforation, obstruction, and chemical injury. Prompt endoscopic removal is guided by established protocols, with emergent intervention required for complete esophageal obstruction and high-risk objects. Various retrieval devices, including forceps, snares, baskets, and overtubes, are used based on the nature of the foreign body. Technological advancements, such as artificial intelligence-assisted imaging and endoscopic ultrasound, are improving diagnostic precision and procedural outcomes. Despite these advances, foreign body ingestion can still lead to severe complications if not managed in a timely manner. Public awareness, preventive measures, and rapid medical response are essential in reducing morbidity and mortality associated with foreign body ingestion.

Keywords: Foreign body removal; Endoscopy; Snare; Forcep; Food bolus; Modern techniques

Core Tip: Foreign body ingestion is a common yet potentially life-threatening emergency, especially in young children and elderly. While most cases resolve spontaneously, some require urgent endoscopic intervention to prevent severe complications like perforation, obstruction, and chemical burns. Advanced endoscopic instruments may be tiny, but they are remarkably smart-capable of maneuvering and extracting foreign objects with precision. Specialized retrieval devices such as forceps, snares, baskets, overtubes, and retrieval nets play a crucial role in safely dislodging and removing impacted items. With evolving technology, endoscopy continues to revolutionize foreign body management, ensuring faster, safer, and more effective patient outcomes.