Buried bumper syndrome: A complication of percutaneous endoscopic gastrostomy

Figure 7 Treatment methods of buried bumper syndrome. A: Extraction of the buried gastrostomy tube with simultaneous pull through of the new one (adapted from[36,63]); B: “Push-pull T technique”. Endoscopist pulls the buried gastrostomy tube by a polypectomy snare anchored using a “T-arm”, while the system is stabilized and pushed inside using a clamp (adapted from[27,72]); C: A polypectomy snare entraps the buried cannula as close to the skin as possible (thanks to splitting) (adapted from[75]); D: Papillotome introduced through a shortened cannula cuts the overgrowing tissue (adapted from[78-81]).