DC current pulses for OTSC clip fragmentation: technology and experimental study

Schostek, Sebastian; Ho, Chi‐Nghia; Melbert, Michael; Krautwald, Martina; Caputo, Antonio Casimiro; Parisi, Giancarlo; Wehrmann, Manfred; Gottwald, Thomas; Schurr, M. O.

doi:10.1007/s00464-014-3935-6

Cited by 18 publications

(13 citation statements)

References 8 publications

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“…Die primäre Entfernung des FTRDClips mithilfe eines Laser oder dem zwischenzeitlich kommerziell angebotenen DC-Cutter (Ovesco, Germany) ist im Falle einer akuten Fehlplatzierung und indizierten Neuanlage oder im Rahmen einer iatrogenen Perforation zur Vorbereitung eines endoskopischen Gewebeverschlusses relativ einfach möglich [19]. Sekundäre, nach längeren Intervallen vorzunehmende Clipentfernungen kön-nen sich mitunter als schwierig erweisen.…”

Section: Tipps Und Tricksunclassified

Full-Thickness-Resection-Device (FTRD)

Richter-Schrag

Walker

Thimme

et al. 2015

Chirurg

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The results show that FTRD is a safe and effective instrument for use in the lower gastrointestinal tract. Limitations of the FTRD system concerning full thickness resection are scarring, fibrosis and thickness of the intestinal wall, especially in the lower rectum; therefore, it is suggested that a simulation with a tube similar in size to the FTRD should be performed during the screening colonoscopy in order to establish whether an endoscopic resection with FTRD is possible.

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Section: Tipps Und Tricksunclassified

Full-Thickness-Resection-Device (FTRD)

Richter-Schrag

Walker

Thimme

et al. 2015

Chirurg

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“…The use of Nd:YAG-Laser was reported in 3 cases and requires further validation 25. A prototype instrumentation that is designed to locally melt the clip by applying an electrical current pulse onto the clip structure has been evaluated in an animal study with promising results 26. Use of a guidewire has also been shown to be a feasible technique for removing the OTSC in an ex vivo porcine model 27.…”

Section: Discussionmentioning

confidence: 99%

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

et al. 2017

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Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.

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“…Several techniques have been described, including an Nd:YAG laser [31], threading a hydrophilic tip guidewire around the clip and then pulling it out [32], and clip fragmentation using DC current pulses. [33]…”

Section: Evolving Techniques In Endoscopic Hemostasismentioning

confidence: 99%

Evolving techniques for gastrointestinal endoscopic hemostasis treatment

Ghassemi

Jensen

2016

Expert Review of Gastroenterology & Hepatology

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With mortality due to gastrointestinal (GI) bleeding remaining stable, the focus on endoscopic hemostasis has been on improving other outcomes such as rebleeding rate, need for transfusions, and need for angiographic embolization or surgery. Over the past few years, a number of devices have emerged to help endoscopically assess and treat bleeding GI lesions. These include the Doppler endoscopic probe, hemostatic powder, and over-the-scope clip. Also, new applications have been described for radiofrequency ablation. In this article, we will discuss these evolving tools and techniques that have been developed, including an analysis of their efficacy and limitations.

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DC current pulses for OTSC clip fragmentation: technology and experimental study

Cited by 18 publications

References 8 publications

Full-Thickness-Resection-Device (FTRD)

Full-Thickness-Resection-Device (FTRD)

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

Evolving techniques for gastrointestinal endoscopic hemostasis treatment

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