Successful transoral forceps insertion of large silicone stents unfit for conventional placement

Tracheoesophageal fistula (TEF) is a life-threatening condition associated with recurrent aspiration and pulmonary infection. Silicone stents are widely used in TEF management because of their removability, biocompatibility, and ability to be customized intraoperatively. However, silicone stents typically require placement under general anesthesia through rigid bronchoscopy. Large modified silicone stents are often unsuitable for conventional placement because of the limited diameter of the rigid bronchoscope and delivery sheath. To address this issue, this article presents a successful case of transoral placement of a silicone stent guided by direct visualization via flexible bronchoscopy, utilizing rigid forceps. This case demonstrates that flexible bronchoscopy-guided transoral placement using rigid forceps may represent a feasible alternative for inserting large modified silicone stents when conventional placement techniques are not suitable.