Is it possible to remove the prosthesis by pushing the device into the esophagus
Issue: can I remove the old prosthesis by pushing the device into the esophagus and let nature take its course
Although it has been common practice for many medical professionals to push the prosthesis through into the esophagus, allowing the device to travel through the intestinal tract, some caution should be given here. Although this rarely has caused problems, some incidences have been reported that are worthwhile mentioning. In our Institute we have had a patient in whom the prosthesis caused esophageal obstruction, because it became trapped onto a till then undetected esophageal carcinoma. There are also reports on a case of sub-acute bowel obstruction in a patient with a history of abdominal surgery. Finally, there is a report on a case of acute appendicitis, in which the voice prosthesis was found in the resection specimen of the appendix. These examples have to be kept in mind if the choice is made to push the prosthesis through the TEP fistula into the esophagus.
Although it has been common practice for many medical professionals to push the prosthesis through into the esophagus, allowing the device to travel through the intestinal tract, some caution should be given here. Although this rarely has caused problems, some incidences have been reported that are worthwhile mentioning. In our Institute we have had a patient in whom the prosthesis caused esophageal obstruction, because it became trapped onto a till then undetected esophageal carcinoma. There are also reports on a case of sub-acute bowel obstruction in a patient with a history of abdominal surgery. Finally, there is a report on a case of acute appendicitis, in which the voice prosthesis was found in the resection specimen of the appendix. These examples have to be kept in mind if the choice is made to push the prosthesis through the TEP fistula into the esophagus.
