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• W4381125612 abstract "<h3>Introduction</h3> Buried bumper syndrome (BBS) occurs when the internal fixation of a percutaneous endoscopic gastrostomy (PEG) tube migrates outside of the stomach lumen along the stoma tract and becomes embeded in the gastric wall.¹ It is a rare late complication which may result in loss of patency of the PEG, tube leakage and abdominal pain. There have been many non-surgical treatment options trialled in the past but none that have shown consistent results.¹ The Flamingo device is a novel tool specifically designed to enable endoscopic removal of buried bumpers. This would reduce the risks associated with a GA and surgical removal as well as improving patient experience. It is a sphincterotome like device connected to diathermy with a 180 degree cutting wire. The overgrown granulation tissue is cut until the bumper is exposed and can be advanced into the stomach.² <h3>Methods</h3> A retrospective data collection was performed for all patients with BBS in which the Flamingo procedure was attempted at our centre. We aimed to determine percentage success rate, average time of completion and whether a second PEG site was needed. We were also able to analyse the amount of sedation required for these procedures in comparison to GA needed for surgical removal. <h3>Results</h3> 12 Procedures were completed at Hospital A, a DGH, between June 2018 and October 2021. 11 of the patients were Male, 1 was female, with an age range of 41 to 88 years of age. 9 of the procedures were successful, a further 1 was successful on the second attempt and 2 needed surgical removal. The patient that needed to undergo a repeat procedure was agitated and desaturated after sedation and the procedure was abandoned. 1 patient was readmitted 4 days post procedure with sepsis secondary to cholecystitis. 1 Flamingo procedure was done under a general anaesthetic (GA). Average time of the procedure was 36mins. Average sedation use was 2mg Midazolam, (range 1–5mg) and 50mcg Fentanyl (range 25–75mcg). <h3>Conclusions</h3> The Flamingo device offers a reliable and reproducible non-surgical technique for the treatment of BBS. As this is a co-morbid group of patients this is particularly beneficial in avoiding the potential risks associated with GA and surgical removal. We have shown that it can be done with minimal sedation and is both safe and less resource intensive than the traditional surgical techniques. It can be done as a day case procedure and helps to avoid hospital admissions which is beneficial both for patients and hospital trusts. The limitations of this study are the small sample size and relatively short study period. <h3>References</h3> Costa D, <i>et al</i>. Multicenter cohort study of patients with buried bumper syndrome treated endoscopically with a novel, dedicated device. <i>Gastrointest Endosc</i>. 2021 Jun;<b>93</b>(6):1325–1332. doi: 10.1016/j.gie.2020.11.009. Epub 2020 Nov 19. PMID: 33221321. Costa D, Despott EJ, Lazaridis N, Koukias N, Murino A. Minimally invasive endoscopic management of buried bumper syndrome by use of a novel dedicated resection device. VideoGIE: an official video. <i>Journal of the American Society for Gastrointestinal Endoscopy</i> 2019;<b>4</b>(8):366–368." @default.
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• W4381125612 date "2023-06-01" @default.
• W4381125612 modified "2023-10-06" @default.
• W4381125612 title "P223 Single centre experience of managing buried percutaneous endoscopic gastrostomy bumper using flamingo device" @default.
• W4381125612 doi "https://doi.org/10.1136/gutjnl-2023-bsg.291" @default.
• W4381125612 hasPublicationYear "2023" @default.
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