How should foreign bodies be removed?
Once identified, nearly all objects can be removed endoscopically. Other modalities have been used with variable success, although major complications have been reported. Prior to endoscopy, a rehearsal of what will be done using retrieval devices that would capture similar-shaped foreign objects is useful. Several endoscopic retrieval tools, such as rat tooth, grasping forceps, baskets, snares, Roth retrieval net, and overtube, are available ( Figure 60-2 ). Protection of the airway, especially in children or combative or older adult patients with poor reflexes and cardiopulmonary reserve, is essential. Consultation with a surgeon is appropriate for cases in which perforation or other major complications are probable. Minimally invasive surgery alone or combined with endoscopy is used increasingly.