Video 1_Case Report: Endoscopic removal of a giant complex gastric trichobezoar: an alternative strategy using combined techniques.mp4

As surgery was declined, endoscopic removal under general anesthesia was performed. The procedure used high-power electrocoagulation (EndoCut/Forced Coag mode) to segment the dense bezoar, followed by piecemeal extraction with forceps and cap-assisted removal to prevent cardia laceration and esophageal injury. The trichobezoar was successfully removed without mucosal injury, and the patient was discharged 4 days after the endoscopic procedure with complete resolution of symptoms.</p>Conclusions<p>With strict patient selection, multidisciplinary teamwork, and adequate expertise and equipment, endoscopic treatment may offer a minimally invasive alternative to the surgical removal of giant gastric trichobezoars in selected pediatric cases.

Psychological support is also important to address underlying behavioral factors that may lead to recurrence.</p>