A Case of Thoracoscopic Foreign Body Retrieval of a Clasp Denture in the Upper Thoracic Esophagus

Abstract

A 71-year-old man accidentally swallowed his clasp denture in August 2023. The physician previously consulted by the patient was unable to remove the denture and referred the patient to our hospital. Computed tomography revealed the presence of a denture in the upper thoracic esophagus. A semi-emergency procedure for foreign body retrieval was performed five days after the accidental swallowing of the denture. Although endoscopic retrieval was attempted upon the induction of general anesthesia, this approach was deemed difficult as capturing the entire image of the denture was unsuccessful. The procedure was converted to a thoracoscopic approach and the denture was retrieved from the upper thoracic esophagus via esophagotomy. Subsequently, the incision was closed using interrupted sutures. Although anastomotic leakage occurred postoperatively, it improved with conservative management. The patient was discharged 29 days postoperatively. Recently, reports on thoracoscopic surgery for esophageal foreign bodies have been published. Esophageal suturing under thoracoscopy remains challenging as the longitudinal direction of the esophagus is perpendicular to that of the forceps on the right hand of the surgeon. In the hereby-presented case, taping and retracting the esophagus to the right side to position it more in parallel to the direction of the forceps was beneficial. In addition, ensuring the suturing of the mucosal edge of the esophageal incision is critical for preventing anastomotic leakage.