Rehmat Ullah Awan, MD1, Kareem Diab, MD1, Muhammad Ahmad Bashir, MD, MBBS, BSc1, Soban maan, MD1, Muhammad Hassaan Arif Maan, MBBS2, Ambreen Nabeel, MBBS1, Jennifer Hadam-Veverka, MD3, Shailendra A. Singh, MD3, Shyam Thakkar, MD1 1West Virginia University, Morgantown, WV; 2Rutgers New Jersey Medical School, Newark, NJ; 3West Virginia University School of Medicine, Morgantown, WV Introduction: Foreign body and food impaction are common clinical emergencies that often require endoscopic intervention. While conventional tools like rat tooth forceps and Roth net retrievers are widely used, the over-the-scope grasper (OTSG) Xcavator has been introduced as a potentially superior tool due to its enhanced grasping strength and stability. However, data on its clinical efficacy and cost-effectiveness remain limited. This case series evaluates the clinical outcomes, efficacy, and safety of the OTSG Xcavator. Methods: A retrospective chart review was conducted at WVU Hospital (June 1, 2024–May 31, 2025), including patients aged ≥ 18 years who underwent foreign body removal using the OTSG Xcavator. Data were collected on demographics, procedure duration, complications, hospital stay, comorbidities, anticoagulant/antiplatelet use, re-intervention rates, concomitant use of other tools, and costs. The primary outcome was clinical success (successful removal without re-intervention). Secondary outcomes included procedure time, hospital stay, and complications. Statistical analysis was performed using SPSS and R. Results: Fourteen procedures were analyzed, with an average patient age of 63.42 years; 57.14% were female. The OTSG Xcavator was used alone in 7 cases (50%). In other instances, it was used in conjunction with other tools: Roth Net in 3 cases (21.43%), Rat Tooth Forceps in 2 cases (14.29%), and Talon in 2 cases (14.29%). Overall clinical success was achieved in 100% of cases, with no complications (e.g., bleeding, perforation, or aspiration) reported. The median post-procedure length of stay was 1 day. No re-interventions were needed. The average procedure duration was 48.50 minutes. Discussion: This case series demonstrates the OTSG Xcavator as a highly effective and safe tool for foreign body and food impaction removal, achieving 100% clinical success without complications or re-intervention. The tool’s enhanced grasping strength and stability contributed to its reliability, particularly in complex cases, where it was used to salvage other tools to achieve clinical success. While clinical efficacy was observed as salvage therapy, the small sample size limits generalizability. Further research, including larger prospective studies, is needed to validate its cost-effectiveness and broader clinical utility.
Figure: OTSG Xcavator
Disclosures: Rehmat Ullah Awan indicated no relevant financial relationships. Kareem Diab indicated no relevant financial relationships. Muhammad Ahmad Bashir indicated no relevant financial relationships. Soban maan indicated no relevant financial relationships. Muhammad Hassaan Arif Maan indicated no relevant financial relationships. Ambreen Nabeel indicated no relevant financial relationships. Jennifer Hadam-Veverka: Abbvie – Speakers Bureau. Johnson & Johnson – Speakers Bureau. Takeda – Speakers Bureau. Shailendra Singh indicated no relevant financial relationships. Shyam Thakkar indicated no relevant financial relationships.
Rehmat Ullah Awan, MD1, Kareem Diab, MD1, Muhammad Ahmad Bashir, MD, MBBS, BSc1, Soban maan, MD1, Muhammad Hassaan Arif Maan, MBBS2, Ambreen Nabeel, MBBS1, Jennifer Hadam-Veverka, MD3, Shailendra A. Singh, MD3, Shyam Thakkar, MD1. P5115 - Efficacy and Safety of Over-the-Scope Grasper (OTSG) Xcavator for Foreign Body and Food Impaction Removal: A Retrospective Case Series, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
