Application of a novel endoscopic device in treatment of gastric bezoars: Pilot study

Abstract Gastric bezoars, especially phytobezoars, are often challenging to treat due to their large size, hardness, and poor response to conventional endoscopic methods, frequently necessitating surgery. This study presents a novel endoscopic device designed to fragment and remove gastric bezoars as a safer and more efficient alternative. In a retrospective single-center study at the Affiliated Hospital of Southwest Medical University, nine patients with giant gastric bezoars (long axis > 3 cm) were treated using this device between November 2023 and March 2025. The device features two outer sheaths symmetrically attached to the lens body, aligned with a transparent cap, and a yellow zebra guidewire running through the sheaths. The guidewire length can be adjusted to modify the snare size, allowing precise bezoar fragmentation. Patients underwent gastroscopy before and after treatment, with follow-up after 1 month. The device successfully fragmented and removed bezoars in all patients, with an average procedure time of approximately 66 minutes (range 33–113 minutes). No complications occurred and follow-up gastroscopy confirmed complete bezoar removal with significant symptom improvement. The novel endoscopic device demonstrated high efficacy and safety in treating gastric bezoars, offering a promising alternative to surgical intervention.