Tristan Petrie described a case of a 46-year-old female patient who developed EGF 20 years after laparoscopic Nissen fundoplication. Patient underwent endoscopic stenting and Ivor-Lewis esophagectomy complicated by anastomotic leak. A repeat esophageal stenting of the remaining esophagus was performed. Patient had persistent dysphagia. An EGD was done for stent removal. A large tracheo-esophageal fistula was found during endoscopy due to stent migration into the trachea causing airway obstruction. This case exemplifies resultant complications of Nissen fundoplication 20 years later. It also underscores the limitation of endoscopic stenting due to the risk of stent migration [11].