Retrieval of a migrated stent using an endoscope inserted into the proximal resected lumen during laparoscopic left hemicolectomy

Abstract

Self-expanding metallic stents (SEMS) are considered feasible for colorectal cancer with bowel obstruction, however, careful observation must be performed following the procedure because of critical morbidity caused by situations such as perforation or migration. The patient was a 61-year-old man who complained of abdominal distension and pain for a few days. A CT revealed advanced transverse colon cancer with bowel obstruction. WallFlexTM Colonic Stent (6 cm) was first placed incompletely, thus, another longer stent (12 cm) was added and bowel obstruction was successfully relieved. On the following day, an abdominal X-ray showed migration of the first stent to the proximal site of the colon. Following total dissipation of small bowel distention, he underwent laparoscopic left hemi-colectomy. Like extracting the colon through a small incision, the migrated stent could be retrieved by the forceps under an endoscope inserted from the proximal resected lumen before anastomosis. Although it is hard to retrieve a migrated colorectal stent, we considered our report could provide a promising option with safety and reliability during laparoscopic colorectal surgery.