A novel endoscopic clip for closing a large perforating wound in a patient undergoing endoscopic full-thickness resection

Zhang, Qiang; Wang, Zhen

doi:10.1055/a-1980-1688

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…“Through‐the‐scope twin endoclips” with regraspable clips on both sides can grasp two different tissues with a single clip (Fig. 2) 65,66 and pass through an accessory channel. Initially, one tooth is opened to grasp the defect margin on one side.…”

Section: Mucosal Defect Closure Using Clipsmentioning

confidence: 99%

Suturing techniques with endoscopic clips and special devices after endoscopic resection

Nomura

Sugimoto

Temma

et al. 2022

Digestive Endoscopy

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Endoscopic submucosal dissection is an established method for complete resection of large and early gastrointestinal tumors. However, methods to reduce bleeding, perforation, and other adverse events after endoscopic resection (ER) have not yet been defined. Mucosal defect closure is often performed endoscopically with a clip. Recently, reopenable clips and large‐teeth clips have also been developed. The over‐the‐scope clip enables complete defect closure by withdrawing the endoscope once and attaching the clip. Other methods involve attaching the clip‐line or a ring with an anchor to appose the edges of the mucosal defect, followed by the use of an additional clip for defect closure. Since clips are limited by their grasping force and size, other methods, such as endoloop closure, endoscopic ligation with O‐ring closure, and the reopenable clip over‐the‐line method, have been developed. In recent years, techniques often utilized for full‐thickness ER of submucosal tumors have been widely used in full‐thickness defect closure. Specialized devices and techniques for defect closure have also been developed, including the curved needle and line, stitches, and an endoscopic tack and suture device. These clips and suture devices are applied for defect closure in emergency endoscopy, accidental perforations, and acute and chronic fistulas. Although endoscopic defect closure with clips has a high success rate, endoscopists need to simplify and promote endoscopic closure techniques to prevent adverse events after ER.

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Section: Mucosal Defect Closure Using Clipsmentioning

confidence: 99%

Suturing techniques with endoscopic clips and special devices after endoscopic resection

Nomura

Sugimoto

Temma

et al. 2022

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

Closure methods for large defects after gastrointestinal endoscopic submucosal dissection

Gong,

Wang,

Song

et al. 2024

J of Gastro and Hepatol

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Nowadays, endoscopic submucosal dissection (ESD) is commonly performed for the removal of large gastrointestinal lesions. Endoscopic mucosal defect closure after ESD is vital to avoid adverse events. In recent years, many innovative instruments have emerged and proved to be beneficial. In this paper, we conducted a thorough literature review and summarized the closure methods for large‐size post‐ESD mucosal defects over decades. We separated these methods into five categories based on the operational principle: “side closure” method, “ring closure” method, “layered closure” method, “hand suturing closure” method, and “specially designed device closure” method. Side closure with clips assisted by instruments such as threads or loops is applicable for each segment of the gastrointestinal tract to prevent postoperative bleeding. If the defect tension is too large to close with the traditional side closure methods, zigzag closure and ring closure could be applied to gather the bilateral defect edges together and achieve continuous closure. In the stomach and rectum with a high risk of submucosal dead space between the submucosa and muscular layers, side closure methods with muscle layer grasping clip or layered closure methods could enable the involvement of the deep submucosa and muscle layers. The ring closure method and specially designed devices including over‐the‐scope clip, Overstitch, and X‐tack could resolve perforation effectively. Individual closure method requires endoscope reinsertion or sophisticated operation, which may be limited by the deep location and the narrow lumen, respectively. Although specially designed devices are expected to offer promising prospectives, the cost‐effectiveness remains to be a problem.

show abstract

A novel endoscopic clip for closing a large perforating wound in a patient undergoing endoscopic full-thickness resection

Cited by 2 publications

References 2 publications

Suturing techniques with endoscopic clips and special devices after endoscopic resection

Suturing techniques with endoscopic clips and special devices after endoscopic resection

Closure methods for large defects after gastrointestinal endoscopic submucosal dissection

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