Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area

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The type of foreign body in the esophagus can vary and include magnets. A magnet that lodges in the esophagus should be extracted within 24 hours to prevent complications due to associated chemical reactions. In rural areas, there are several limitations to extracting FBs from the esophagus. We report a case of a magnetic FB that lodged in the esophagus of a three-year-old boy. The extraction was successfully done by esophagoscopy with the modification of a hook that was attached to the endoscope. This innovation may help physician all over the world, especially in rural areas. In the future, this innovation could be produced on an industrial scale." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/12-7", "name": "Case Report: Modified endoscopic hook for extracting magnetic esophageal..." } } ] } Home Browse Case Report: Modified endoscopic hook for extracting magnetic esophageal... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Kadriyan H, Primayanti I, Syamsidar S et al. Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.12688/f1000research.129564.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Case Report Revised Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] Hamsu Kadriyan https://orcid.org/0000-0002-2574-9785 1 , Ika Primayanti 2 , Syamsidar Syamsidar 3 , Lalu Fauzan Fakhrussiam 3 , Moh Fahrur Rozi 3 , Hijrinelly Hijrinelly 4 Hamsu Kadriyan https://orcid.org/0000-0002-2574-9785 1 , Ika Primayanti 2 , [...] Syamsidar Syamsidar 3 , Lalu Fauzan Fakhrussiam 3 , Moh Fahrur Rozi 3 , Hijrinelly Hijrinelly 4 PUBLISHED 25 Jul 2024 Author details Author details 1 Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, West Nusa Tenggara, 83125, Indonesia 2 Public Health, Faculty of Medicine, University of Mataram, Mataram, West Nusa Tenggara, 83125, Indonesia 3 Nursing Surgery, West Nusa Tenggara Hospital, Mataram, West Nusa Tenggara, 83126, Indonesia 4 Anesthesiology and reanimation, Faculty of Medicine, University of Mataram, Mataram, West Nusa Tenggara, 83125, Indonesia Hamsu Kadriyan Roles: Conceptualization, Data Curation, Writing – Original Draft Preparation, Writing – Review & Editing Ika Primayanti Roles: Validation, Writing – Review & Editing Syamsidar Syamsidar Roles: Conceptualization, Resources Lalu Fauzan Fakhrussiam Roles: Resources, Visualization Moh Fahrur Rozi Roles: Resources, Visualization Hijrinelly Hijrinelly Roles: Validation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Foreign bodies (FB) in the aerodigestive tract are common, especially in children. The type of foreign body in the esophagus can vary and include magnets. A magnet that lodges in the esophagus should be extracted within 24 hours to prevent complications due to associated chemical reactions. In rural areas, there are several limitations to extracting FBs from the esophagus. We report a case of a magnetic FB that lodged in the esophagus of a three-year-old boy. The extraction was successfully done by esophagoscopy with the modification of a hook that was attached to the endoscope. This innovation may help physician all over the world, especially in rural areas. In the future, this innovation could be produced on an industrial scale. READ ALL READ LESS Keywords Foreign bodies, aerodigestive tract, endoscopic hook, esophagoscopy Corresponding Author(s) Hamsu Kadriyan ( [email protected] ) Close Corresponding author: Hamsu Kadriyan Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Kadriyan H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Kadriyan H, Primayanti I, Syamsidar S et al. Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.12688/f1000research.129564.3 ) First published: 04 Jan 2023, 12 :7 ( https://doi.org/10.12688/f1000research.129564.1 ) Latest published: 25 Jul 2024, 12 :7 ( https://doi.org/10.12688/f1000research.129564.3 ) Revised Amendments from Version 2 There are some important additional issues inserted on the new file to explain the safety and potential side effect of this innovation. There is also an additional picture to make a better understanding about the properties of this innovation. Therefore, the other physician can reproduced this innovation in the future. There are some important additional issues inserted on the new file to explain the safety and potential side effect of this innovation. There is also an additional picture to make a better understanding about the properties of this innovation. Therefore, the other physician can reproduced this innovation in the future. See the authors' detailed response to the review by Dian Adi Syahputra See the authors' detailed response to the review by Ali Bilal Ulas See the authors' detailed response to the review by Mingyan Cai READ REVIEWER RESPONSES Introduction Although a warning regarding choking risk has been included on every toy by the factory, 1 cases of foreign body (FB) in the upper aerodigestive tract remain frequently found in the clinical setting. Several types of FBs can be found in the upper aerodigestive tract, including coins, magnets, batteries, pins, and organic substances such as peanuts, meat, among others. 2 – 4 The effect of FBs in the aerodigestive tract varies, depending on its location. If the FB is lodged in the esophagus, it will cause dysphagia, while in the bronchus it may cause airway obstruction and lead to mortality. 2 , 3 The part of a toy such as a magnet can usually found in children and may cause perforation or fistula on the esophagus. This complication occurs because of the effect of the chemical reaction between the magnet with the esophagus tissue. Therefore, a magnet FB in the esophagus should be extracted within 24 hours of the finding. 3 – 5 The extraction of FBs from the esophagus may be challenging, especially in a rural area with limited equipment. An endoscope or esophagoscope, and a forceps or extractor are not complete or do not fit with the type or shape of the FBs. Therefore, in rural areas, the physician should try to do their best to help the patient with those limitations. In this report, the authors would like to share the modification of the hook that is attached to the rigid endoscope. This modification successfully extracted a big and thick heart-shaped magnet in the esophagus. Case presentation A three-year-old boy was referred from the primary hospital with FBs lodged in the esophagus 1 hour prior to the hospitalization. He accidentally ingested the magnet toys while playing with his sister. After the incident, the boy was crying and his sister told their mother that her brother had ingested the toy part. His sister showed the shape of FB that was ingested to their mother. Therefore, the boy was then brought to the hospital to see whether the FB was lodged somewhere or not. There was no sign of coughing or dyspnea in this patient. An x-ray examination was done to know the location of the FBs in the upper aerodigestive tract. The result showed the radiopaque metallic object with a heart shape was lodged in the upper esophagus ( Figure 1A and B ). After the diagnosis was established, the patient was scheduled for an esophagoscopy to extract the FB under general anesthesia. Figure 1. The X-ray images showed the metallic density with the heart shape (blue arrow) (A: anterior-posterior projection; B: lateral projection). During the esophagoscopy, several forceps and baskets were tried to extract the FB, however, the FB was moving down to the middle part. After several attempts, the authors then tried to modify the endoscope by placing the additional hook on the tip of the rigid scope ( Figure 2A , red arrow). Finally, the FB could be extracted without any complications, however, the color of the FB has changed ( Figure 2A , yellow arrow) from its original color ( Figure 2A , green arrow). Figure 2. A. The FB extraction under endoscope view (blue arrow: the FB; red arrow: the hook; green arrow: original magnet). B. Schematic design of rigid esophagoscope (blue tubular) with modified hook (brown line) that attached to rigid scope (green line). Follow-up after surgery was done after two (2) days, and no complications occurred. The patient was then released from the ward. A week after the surgery, the patient came to the outpatient clinic. No difficulties in swallowing were found, and the patient could eat all kinds of food. Discussion The constraints in managing certain cases in rural areas may be unexpected; therefore, some physicians may refer the patient to a bigger/higher hospital if they encounter difficulties. In some archipelago countries, the transportation between the islands may become a problem. Some small islands may only have boating infrastructure; on the other hand, larger islands may have a more complete transportation infrastructure. In some cases, the patient or their family may not agree to be referred to another hospital on other islands. Another patient may delay the treatment time for another reason, for instance, costs considerations and low awareness of disease symptoms. 6 , 7 As such, the diseases may develop into a more dangerous condition. In the gastrointestinal magnetic FB, it could promote a fistula or perforation. 5 Therefore, the physician should apply their best competencies to manage the cases. On the other hand, the patients safety must be a priority. One of the general constraints faced in rural areas is inadequate equipment. The other constraint is manpower. 7 The hospital level in some countries is divided into primary to tertiary. Primary hospitals usually have simple equipment and manpower. On the other hand, tertiary hospitals have complete equipment and manpower. 8 In Indonesia in 2021 there were only 16 of 34 provinces who have tertiary hospitals, the rest were primary and secondary hospitals. Mostly, the provinces that have tertiary hospitals are located on the big island such as Java island. 9 Anatomically, there are several narrow points in the esophagus, consecutively upper, middle, and lower as the common site of FB lodging. The most common lodging site is upper part of esophagus. 10 In a rural area such as Africa and Spain, the use of rigid esophagoscope/bronchoscope remain the major procedure for managing FB in aerodigestive tracts. 11 , 12 This condition is similar to the condition in our region, rigid esophagoscope remains used to extract the FB in the upper digestive tract. Our island is a small island and the distance to the nearest island which has a better health facilities is 4-5 hours by boat. The modification of this hook was inspired by the cerumen hook that is routinely used by the otolaryngologist to remove the hard wax or FB in the ear canal. 13 Therefore, the principle is alike to a cerumen hook. To make it visible, the hook was attached to the rigid scope. Therefore, the FB extraction could be done safely with direct vision. The other concern is the hook should be in a safe mode for the esophagus, with non-sharp tip for example. The schematic design of this equipment ( Figure 2B ) could be used to understand it’s properties. The extraction itself started with the insertion of a rigid esophagoscope into the esophagus until it was close to the FB location. Then, the hook attached to the scope was inserted through the lumen of the esophagoscope. The hook insertion should be done smoothly in a similar direction to the FB position and esophagus wall ( Figure 2A ) to prevent a wound that may provoke a perforation. After passing the edge of the FB, the hook direction was then rotated to the body of FB and extracted slowly. If it does not work on the first attempt, the procedure could be repeated until the FB is successfully removed. However, if it is remain fail, the patient should be refer to a better referral health center. The application of a hook is suitable for a quadrangle- or triangle-shape FB with a certain thickness (thicker than a coin). According to a previous publication, a hook for extracting FB in the esophagus is not available. 4 Therefore, this modification is the first innovation of the kind published in a journal. Hopefully, this innovation could help physicians globally, especially in rural areas. This innovation may also be used as an inspiration to modify incomplete equipment in a rural area. However, advanced research should be done to prove it’s safety and efficacy profile. Therefore, in the future, this modification could be produced on an industrial scale. Conclusions The modified endoscopic hook is an innovation that is suitable and safe for extracting quadrangle or triangle FB shapes in the esophagus with a certain thickness. Consent of the patient’s parents The written consent for using the images and publishing this case report has been given by the parent of the patient. References 1. Child Safety Central: Consumer Product Safety Commission: Child Safety Protection Act Fact Sheet.2006. Reference Source Reference Source 2. Gezer HO, Ezer SS, Temiz A, et al. : Ingested foreign bodies in children: Do they really pass spontaneously from the gastrointestinal tract? A single-centre experience with 1000 cases. Ulus. Travma Acil Cerrahi Derg. 2020; 26 : 247–254. PubMed Abstract | Publisher Full Text 3. Altokhais TI, Al-Saleem A, Gado A, et al. : Esophageal foreign bodies in children: Emphasis on complicated cases. Asian J. Surg. 2017; 40 : 362–366. PubMed Abstract | Publisher Full Text 4. Magalhães-Costa P, Carvalho L, Rodrigues JP, et al. : Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article. GE Port. J. Gastroenterol. 2016; 23 (3): 142–152. PubMed Abstract | Publisher Full Text | Free Full Text 5. Negoita LM, Catalin SG, Constantinescu G, et al. : Esophageal food impaction and foreign object ingestion in gastrointestinal tract: A review of clinical and endoscopic management. Gastroenterol. Insights. 2023; 14 (1): 131–143. Publisher Full Text 6. Kadriyan H, Endriani E, Andiwijaya FR, et al. : Upper airway obstruction due to bilateral laryngeal polyp: A challenge of treatment in rural area. Crit. Care Shock. 2021; 2021 (July): 212–217. 7. Soepardi EA: Problem in managing foreign bodies in upper aerodigestive tract. Med. J. Indones. 2002; 11 (1): 15–18. Publisher Full Text 8. Lele L, Du T, Hu Y: The effect of different classification of hospitals on medical expenditure from perspective of classification of hospitals framework: Evidence from china. Cost Eff. Resour. Alloc. 2020; 18 : 1–12. Publisher Full Text 9. Anonim.: 60 Rumah Sakit RS Tipe A di Indonesia|Alamat, Telepon dan Kepemilikannya|Semua Kota dan Kabupaten. Update. 2021. https://www.avitaliahealth.com/2018/05/daftar-rumah-sakit-rs-tipe-di-indonesia.html 10. Altamimi E, Yusef D, Rawabdeh N: Endoscopic management of foreign body ingestion in children. Prz. Gastroenterol. 2020; 15 (4): 349–353. PubMed Abstract | Publisher Full Text | Free Full Text 11. Gilyoma JM, Chalya PL: Endoscopic procedures for removal of foreign bodies of the aerodigestive tract: The bugando medical centre experience. BMC Ear Nose Throat Disord. 2011; 11 : 2. PubMed Abstract | Publisher Full Text | Free Full Text 12. Delgado-Plasencia L, Manes-Bonet N, Torres Monzón E: Management of foreign body in esophagus with rigid bronchoscopy. Am. J. Emerg. Med. 2010; 28 (1): 116.e5–6. PubMed Abstract | Publisher Full Text 13. Watkins C, McCalla CD: Foreign bodies of the head and neck. Pediatr. Emerg. Med. Rep. 2016; 21 (7): 1–15. Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 04 Jan 2023 ADD YOUR COMMENT Comment Author details Author details 1 Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, West Nusa Tenggara, 83125, Indonesia 2 Public Health, Faculty of Medicine, University of Mataram, Mataram, West Nusa Tenggara, 83125, Indonesia 3 Nursing Surgery, West Nusa Tenggara Hospital, Mataram, West Nusa Tenggara, 83126, Indonesia 4 Anesthesiology and reanimation, Faculty of Medicine, University of Mataram, Mataram, West Nusa Tenggara, 83125, Indonesia Hamsu Kadriyan Roles: Conceptualization, Data Curation, Writing – Original Draft Preparation, Writing – Review & Editing Ika Primayanti Roles: Validation, Writing – Review & Editing Syamsidar Syamsidar Roles: Conceptualization, Resources Lalu Fauzan Fakhrussiam Roles: Resources, Visualization Moh Fahrur Rozi Roles: Resources, Visualization Hijrinelly Hijrinelly Roles: Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 25 Jul 2024, 12:7 https://doi.org/10.12688/f1000research.129564.3 version 2 Revised Published: 23 Nov 2023, 12:7 https://doi.org/10.12688/f1000research.129564.2 version 1 Published: 04 Jan 2023, 12:7 https://doi.org/10.12688/f1000research.129564.1 Copyright © 2024 Kadriyan H et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Kadriyan H, Primayanti I, Syamsidar S et al. Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.12688/f1000research.129564.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 25 Jul 2024 Revised Views 0 Cite How to cite this report: Ulas AB. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306971 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306971 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Aug 2024 Ali Bilal Ulas , Ataturk University, Erzurum, Turkey Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.169472.r306971 It is erroneous to assume that the fact the procedure is performed under optical observation makes it safe. There is a risk of sudden shifts in the hook and serious injuries during manipulation of the object. As this field is ... Continue reading READ ALL It is erroneous to assume that the fact the procedure is performed under optical observation makes it safe. There is a risk of sudden shifts in the hook and serious injuries during manipulation of the object. As this field is not within the authors' own field of expertise, they are unable to grasp the seriousness of the work. Such risky interventions cannot be considered as innovations in the field of oesophageal surgery. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Thoracic Surgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ulas AB. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306971 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306971 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Cai M. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306970 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306970 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Aug 2024 Mingyan Cai , Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China Approved VIEWS 0 https://doi.org/10.5256/f1000research.169472.r306970 No ... Continue reading READ ALL No further comments Competing Interests: No competing interests were disclosed. Reviewer Expertise: Endoscopy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Cai M. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306970 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306970 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 23 Nov 2023 Revised Views 0 Cite How to cite this report: Ulas AB. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r302670 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-302670 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 18 Jul 2024 Ali Bilal Ulas , Ataturk University, Erzurum, Turkey Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.159125.r302670 The article presents a case report of a child with a magnetic foreign body lodged in the esophagus, highlighting the difficulties faced in rural areas, such as limited equipment and manpower, and the need for innovative solutions. ... Continue reading READ ALL The article presents a case report of a child with a magnetic foreign body lodged in the esophagus, highlighting the difficulties faced in rural areas, such as limited equipment and manpower, and the need for innovative solutions. While the statement ‘the lower esophagus is the most common site of foreign body lodging’ is incorrect, it is important to evaluate the method proposed in the article beyond its content. The technique, which is considered an innovation, makes a statement that is contrary to established medical practice. The modified endoscopic hook technique is not an innovation, and it is neither suitable nor safe. Primum non nocere (First, do no harm)! Patient safety must remain the highest priority. I appreciate the challenges the authors faced and their good intentions in attempting to avoid perforation with a magnet. However, using a hook in the esophagus will undoubtedly cause more serious complications, such as damage to the trachea, aorta, and other organs, or mediastinitis, which will inevitably lead to significant outcomes. It is imperative that any unnecessary interventions that could lead to malpractice and compromise patient safety are avoided. The authors suggest repeating the procedure if it does not work on the first attempt. As thoracic surgeons, we strongly advise against repeated attempts due to the risk of iatrogenic esophageal perforations, which can cause serious complications. The article does not sufficiently discuss potential risks or complications associated with the modified tool. It is imperative to question why a hook for extracting foreign bodies in the esophagus is not available. Serious mortality and significant mortal consequences are associated with such interventions. Furthermore, the authors confirm that if the case had been in an urban area, a flexible endoscope would have been used. However, the authors were mistakenly concerned about urgent intervention for the esophageal SINGLE magnet. Even in centers with rigid and flexible endoscopes, multiprong forceps, hinged types of forceps, basket retrieval forceps, net retrieval devices, snares, high patient volume, and experienced hands, there is a possibility of complications. It would be more appropriate to perform such interventions in centers with multidisciplinary teams that can manage any complications that may arise. In conclusion, although the authors' intentions are understood and appreciated, the proposed method is not safe or advisable. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? No Is the case presented with sufficient detail to be useful for other practitioners? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Thoracic Surgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Ulas AB. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r302670 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-302670 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 25 Jul 2024 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 25 Jul 2024 Author Response Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. ... Continue reading Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. The most common lodging site is upper part of esophagus” to prevent the misunderstandings. To better understand the safety nature of this innovation, the authors have added the schematic picture of the innovation (Figure 2B). Therefore, it can be used more safely. The potential impact of using hooks has been mention in paragraph 4 on the discussion heading. If FB extraction fails with this method, the authors rely on the patient to be referred to a better hospital. (Paragraph 3 and 4 on the discussion heading) The authors also believe that with this case report, we cannot definitively determine the safety and efficacy of this innovation. Therefore, the authors propose that better studies with a better methods may be conducted in the future to prove its safety and efficacy properties (last paragraph of the discussion title). Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. The most common lodging site is upper part of esophagus” to prevent the misunderstandings. To better understand the safety nature of this innovation, the authors have added the schematic picture of the innovation (Figure 2B). Therefore, it can be used more safely. The potential impact of using hooks has been mention in paragraph 4 on the discussion heading. If FB extraction fails with this method, the authors rely on the patient to be referred to a better hospital. (Paragraph 3 and 4 on the discussion heading) The authors also believe that with this case report, we cannot definitively determine the safety and efficacy of this innovation. Therefore, the authors propose that better studies with a better methods may be conducted in the future to prove its safety and efficacy properties (last paragraph of the discussion title). Competing Interests: I have confirm that I don't have any competing interest Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 25 Jul 2024 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 25 Jul 2024 Author Response Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. ... Continue reading Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. The most common lodging site is upper part of esophagus” to prevent the misunderstandings. To better understand the safety nature of this innovation, the authors have added the schematic picture of the innovation (Figure 2B). Therefore, it can be used more safely. The potential impact of using hooks has been mention in paragraph 4 on the discussion heading. If FB extraction fails with this method, the authors rely on the patient to be referred to a better hospital. (Paragraph 3 and 4 on the discussion heading) The authors also believe that with this case report, we cannot definitively determine the safety and efficacy of this innovation. Therefore, the authors propose that better studies with a better methods may be conducted in the future to prove its safety and efficacy properties (last paragraph of the discussion title). Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. The most common lodging site is upper part of esophagus” to prevent the misunderstandings. To better understand the safety nature of this innovation, the authors have added the schematic picture of the innovation (Figure 2B). Therefore, it can be used more safely. The potential impact of using hooks has been mention in paragraph 4 on the discussion heading. If FB extraction fails with this method, the authors rely on the patient to be referred to a better hospital. (Paragraph 3 and 4 on the discussion heading) The authors also believe that with this case report, we cannot definitively determine the safety and efficacy of this innovation. Therefore, the authors propose that better studies with a better methods may be conducted in the future to prove its safety and efficacy properties (last paragraph of the discussion title). Competing Interests: I have confirm that I don't have any competing interest Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Syahputra DA. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r225008 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-225008 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 15 Dec 2023 Dian Adi Syahputra , Department of Surgery, Syiah Kuala University, Banda Aceh, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.159125.r225008 Thank you for the revision. Suggestions to the author are mainly regarding the discussion of oesophageal anatomy and the most common site of foreign body impaction. Reference 10 states that the most common site is the upper esophagus ... Continue reading READ ALL Thank you for the revision. Suggestions to the author are mainly regarding the discussion of oesophageal anatomy and the most common site of foreign body impaction. Reference 10 states that the most common site is the upper esophagus at around 50%, contrary to the author's statement in the discussion section that it is the lower esophagus. The reference below supports the statement that the upper esophagus is the most common site. Please be very careful in writing statements in declared articles. Thank you. Shruti Jayachandra, Guy D. Eslick, A systematic review of paediatric foreign body ingestion: Presentation, complications, and management, International Journal of Pediatric Otorhinolaryngology, Volume 77, Issue 3, 2013, Pages 311-317, ISSN 0165-5876, https://doi.org/10.1016/j.ijporl.2012.11.025. (https://www.sciencedirect.com/science/article/pii/S0165587612006519) Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pediatric Surgeon I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Syahputra DA. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r225008 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-225008 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 04 Jan 2023 Views 0 Cite How to cite this report: Syahputra DA. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r161310 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-161310 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 15 Nov 2023 Dian Adi Syahputra , Department of Surgery, Syiah Kuala University, Banda Aceh, Indonesia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.142254.r161310 A beneficial case report on managing FB in areas with limited resources. There are some comments to improve this case report to make it better for readers. The author should not use the ... Continue reading READ ALL A beneficial case report on managing FB in areas with limited resources. There are some comments to improve this case report to make it better for readers. The author should not use the term "otolaryngologists" in this case report, especially in the abstract and the last paragraph of the discussion. It is better to use global terms such as doctors or physicians. In the discussion section, the author should discuss the anatomy of the esophagus, which results in the retention of the FB in the esophagus to the stomach. The author should refrain from doing self-citation in this report because there are 2 self-citations in the references. Many case reports discuss FB in children, especially in the esophagus. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Pediatric Surgeon I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Syahputra DA. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r161310 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-161310 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 23 Nov 2023 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 23 Nov 2023 Author Response Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. ... Continue reading Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. I have added the anatomy of the esophagus in the discussion section. 3. To prevent self-citation I deleted one of the references, but the other one is significant to support the explanation of health services problem in a rural area. I also added some other references to support the importance of this manuscript. Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. I have added the anatomy of the esophagus in the discussion section. 3. To prevent self-citation I deleted one of the references, but the other one is significant to support the explanation of health services problem in a rural area. I also added some other references to support the importance of this manuscript. Competing Interests: I have no conflict of interest Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 23 Nov 2023 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 23 Nov 2023 Author Response Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. ... Continue reading Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. I have added the anatomy of the esophagus in the discussion section. 3. To prevent self-citation I deleted one of the references, but the other one is significant to support the explanation of health services problem in a rural area. I also added some other references to support the importance of this manuscript. Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. I have added the anatomy of the esophagus in the discussion section. 3. To prevent self-citation I deleted one of the references, but the other one is significant to support the explanation of health services problem in a rural area. I also added some other references to support the importance of this manuscript. Competing Interests: I have no conflict of interest Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Cai M. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r165757 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-165757 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 15 Nov 2023 Mingyan Cai , Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.142254.r165757 The authors described a modified endoscopic hook for extracting magnetic esophageal foreign body. It has some novelty, but such big magnetic foreign body will not always successfully hooked by the small hook. The reproduction of the result is limited in ... Continue reading READ ALL The authors described a modified endoscopic hook for extracting magnetic esophageal foreign body. It has some novelty, but such big magnetic foreign body will not always successfully hooked by the small hook. The reproduction of the result is limited in other cases, since the hook itself sometimes won't have enough power to extract the foreign body from the narrowing space of the esophageal entrance. GI endoscopy with accessary channels through which can apply a series of accessories has more advantages than this rigid scope. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Endoscopy I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Cai M. Reviewer Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r165757 ) The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-165757 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 23 Nov 2023 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 23 Nov 2023 Author Response Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I ... Continue reading Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I agree to the use of a flexible endoscope. To support the importance of this innovation in rural areas, I have inserted some references in the discussion section Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I agree to the use of a flexible endoscope. To support the importance of this innovation in rural areas, I have inserted some references in the discussion section Competing Interests: I have no conflict of interest Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 23 Nov 2023 hamsu kadriyan , Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia 23 Nov 2023 Author Response Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I ... Continue reading Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I agree to the use of a flexible endoscope. To support the importance of this innovation in rural areas, I have inserted some references in the discussion section Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I agree to the use of a flexible endoscope. To support the importance of this innovation in rural areas, I have inserted some references in the discussion section Competing Interests: I have no conflict of interest Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 04 Jan 2023 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 3 (revision) 25 Jul 24 read read Version 2 (revision) 23 Nov 23 read read Version 1 04 Jan 23 read read Mingyan Cai , Fudan University, Shanghai, China Dian Adi Syahputra , Syiah Kuala University, Banda Aceh, Indonesia Ali Bilal Ulas , Ataturk University, Erzurum, Turkey Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Ulas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Aug 2024 | for Version 3 Ali Bilal Ulas , Ataturk University, Erzurum, Turkey 0 Views copyright © 2024 Ulas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions It is erroneous to assume that the fact the procedure is performed under optical observation makes it safe. There is a risk of sudden shifts in the hook and serious injuries during manipulation of the object. As this field is not within the authors' own field of expertise, they are unable to grasp the seriousness of the work. Such risky interventions cannot be considered as innovations in the field of oesophageal surgery. Competing Interests No competing interests were disclosed. Reviewer Expertise Thoracic Surgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Ulas AB. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306971) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306971 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Cai M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Aug 2024 | for Version 3 Mingyan Cai , Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China 0 Views copyright © 2024 Cai M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions No further comments Competing Interests No competing interests were disclosed. Reviewer Expertise Endoscopy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Cai M. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.169472.r306970) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v3#referee-response-306970 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Ulas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 18 Jul 2024 | for Version 2 Ali Bilal Ulas , Ataturk University, Erzurum, Turkey 0 Views copyright © 2024 Ulas A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article presents a case report of a child with a magnetic foreign body lodged in the esophagus, highlighting the difficulties faced in rural areas, such as limited equipment and manpower, and the need for innovative solutions. While the statement ‘the lower esophagus is the most common site of foreign body lodging’ is incorrect, it is important to evaluate the method proposed in the article beyond its content. The technique, which is considered an innovation, makes a statement that is contrary to established medical practice. The modified endoscopic hook technique is not an innovation, and it is neither suitable nor safe. Primum non nocere (First, do no harm)! Patient safety must remain the highest priority. I appreciate the challenges the authors faced and their good intentions in attempting to avoid perforation with a magnet. However, using a hook in the esophagus will undoubtedly cause more serious complications, such as damage to the trachea, aorta, and other organs, or mediastinitis, which will inevitably lead to significant outcomes. It is imperative that any unnecessary interventions that could lead to malpractice and compromise patient safety are avoided. The authors suggest repeating the procedure if it does not work on the first attempt. As thoracic surgeons, we strongly advise against repeated attempts due to the risk of iatrogenic esophageal perforations, which can cause serious complications. The article does not sufficiently discuss potential risks or complications associated with the modified tool. It is imperative to question why a hook for extracting foreign bodies in the esophagus is not available. Serious mortality and significant mortal consequences are associated with such interventions. Furthermore, the authors confirm that if the case had been in an urban area, a flexible endoscope would have been used. However, the authors were mistakenly concerned about urgent intervention for the esophageal SINGLE magnet. Even in centers with rigid and flexible endoscopes, multiprong forceps, hinged types of forceps, basket retrieval forceps, net retrieval devices, snares, high patient volume, and experienced hands, there is a possibility of complications. It would be more appropriate to perform such interventions in centers with multidisciplinary teams that can manage any complications that may arise. In conclusion, although the authors' intentions are understood and appreciated, the proposed method is not safe or advisable. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? No Is the case presented with sufficient detail to be useful for other practitioners? No Competing Interests No competing interests were disclosed. Reviewer Expertise Thoracic Surgery I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 25 Jul 2024 hamsu kadriyan, Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia Dear Reviewer, Thank you on reviewing my article. The statement regarding the commonest site of FB lodging was change to “as the common site of FB lodging. The most common lodging site is upper part of esophagus” to prevent the misunderstandings. To better understand the safety nature of this innovation, the authors have added the schematic picture of the innovation (Figure 2B). Therefore, it can be used more safely. The potential impact of using hooks has been mention in paragraph 4 on the discussion heading. If FB extraction fails with this method, the authors rely on the patient to be referred to a better hospital. (Paragraph 3 and 4 on the discussion heading) The authors also believe that with this case report, we cannot definitively determine the safety and efficacy of this innovation. Therefore, the authors propose that better studies with a better methods may be conducted in the future to prove its safety and efficacy properties (last paragraph of the discussion title). View more View less Competing Interests I have confirm that I don't have any competing interest reply Respond Report a concern Ulas AB. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r302670) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-302670 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Syahputra D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 15 Dec 2023 | for Version 2 Dian Adi Syahputra , Department of Surgery, Syiah Kuala University, Banda Aceh, Indonesia 0 Views copyright © 2023 Syahputra D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the revision. Suggestions to the author are mainly regarding the discussion of oesophageal anatomy and the most common site of foreign body impaction. Reference 10 states that the most common site is the upper esophagus at around 50%, contrary to the author's statement in the discussion section that it is the lower esophagus. The reference below supports the statement that the upper esophagus is the most common site. Please be very careful in writing statements in declared articles. Thank you. Shruti Jayachandra, Guy D. Eslick, A systematic review of paediatric foreign body ingestion: Presentation, complications, and management, International Journal of Pediatric Otorhinolaryngology, Volume 77, Issue 3, 2013, Pages 311-317, ISSN 0165-5876, https://doi.org/10.1016/j.ijporl.2012.11.025. (https://www.sciencedirect.com/science/article/pii/S0165587612006519) Competing Interests No competing interests were disclosed. Reviewer Expertise Pediatric Surgeon I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Syahputra DA. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.159125.r225008) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v2#referee-response-225008 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Syahputra D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 15 Nov 2023 | for Version 1 Dian Adi Syahputra , Department of Surgery, Syiah Kuala University, Banda Aceh, Indonesia 0 Views copyright © 2023 Syahputra D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions A beneficial case report on managing FB in areas with limited resources. There are some comments to improve this case report to make it better for readers. The author should not use the term "otolaryngologists" in this case report, especially in the abstract and the last paragraph of the discussion. It is better to use global terms such as doctors or physicians. In the discussion section, the author should discuss the anatomy of the esophagus, which results in the retention of the FB in the esophagus to the stomach. The author should refrain from doing self-citation in this report because there are 2 self-citations in the references. Many case reports discuss FB in children, especially in the esophagus. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Pediatric Surgeon I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 23 Nov 2023 hamsu kadriyan, Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia Dear reviewer, Thank you for your comment on my article. Regarding your suggestion, I have revised the article as follows: 1. I have changed the word "otolaryngologist" to "physician". 2. I have added the anatomy of the esophagus in the discussion section. 3. To prevent self-citation I deleted one of the references, but the other one is significant to support the explanation of health services problem in a rural area. I also added some other references to support the importance of this manuscript. View more View less Competing Interests I have no conflict of interest reply Respond Report a concern Syahputra DA. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r161310) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-161310 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Cai M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 15 Nov 2023 | for Version 1 Mingyan Cai , Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China 0 Views copyright © 2023 Cai M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors described a modified endoscopic hook for extracting magnetic esophageal foreign body. It has some novelty, but such big magnetic foreign body will not always successfully hooked by the small hook. The reproduction of the result is limited in other cases, since the hook itself sometimes won't have enough power to extract the foreign body from the narrowing space of the esophageal entrance. GI endoscopy with accessary channels through which can apply a series of accessories has more advantages than this rigid scope. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Endoscopy I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 23 Nov 2023 hamsu kadriyan, Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Mataram, Indonesia, 83125, Indonesia Dear Reviewer Thank you for your comment on my manuscript. The setting of this case was in a rural area. If the case was found in an urban area, I agree to the use of a flexible endoscope. To support the importance of this innovation in rural areas, I have inserted some references in the discussion section View more View less Competing Interests I have no conflict of interest reply Respond Report a concern Cai M. Peer Review Report For: Case Report: Modified endoscopic hook for extracting magnetic esophageal foreign bodies in a rural area [version 3; peer review: 2 approved, 1 not approved] . F1000Research 2024, 12 :7 ( https://doi.org/10.5256/f1000research.142254.r165757) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-7/v1#referee-response-165757 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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