Skip to main content
SpringerLink
Log in

Full-Thickness Closure of Iatrogenic or Post-Interventional Gastrointestinal Defect by the Use of Flexible Endoluminal Suturing Device

  • Reference work entry
  • First Online:
Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

  • 137 Accesses

Abstract

Traditionally, surgical intervention has represented the mainstay for the treatment of endoscopic gastrointestinal (GI) perforations. However, the recent development of innovative endoscopic devices able to perform full-thickness closure of such defects, including both over-the-scope clips and endoscopic suturing devices, is revolutionary changing this therapeutic paradigm. In the next future, a step-up approach with surgery restricted to highly selected cases of endoscopic perforations only could represent the optimal strategy for the repair of such defects.

In this chapter, full-thickness closure of iatrogenic or post-interventional (i.e., Endoscopic Submucosal Dissection) defect by means of the OverStitch Endoscopic Suturing System, the only endoscopic suturing device widely approved to date, will extensively discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 699.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 849.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Kumar N, Thompson CC (2013) Endoscopic management of complications after gastrointestinal weight loss surgery. Clin Gastroenterol Hepatol 11:343–353

    Article  PubMed  Google Scholar 

  2. Keren D, Eyal O, Sroka G et al (2015) Over-the-scope clip (OTSC) system for sleeve gastrectomy leaks. Obes Surg 25:1358–1363

    Article  CAS  PubMed  Google Scholar 

  3. Kantsevoy SV, Armengol-Miro JR (2016) Endoscopic suturing, an essential enabling technology for new NOTES interventions. Gastrointest Endosc Clin N Am 26:375–384

    Article  PubMed  Google Scholar 

  4. Chiu PW, Hu B, Lau JY et al (2006) Endoscopic plication of massively bleeding peptic ulcer by using the Eagle Claw VII device: a feasibility study in a porcine model. Gastrointest Endosc 63:681–685

    Article  PubMed  Google Scholar 

  5. Paspatis GA, Arvanitakis M, Dumonceau JM et al (2020) Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement – update 2020. Endoscopy 52:792–810

    Article  PubMed  Google Scholar 

  6. Paspatis GA, Dumonceau JM, Barthet M et al (2014) Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy 46:693–711

    Article  PubMed  Google Scholar 

  7. Kojima T, Parra-Blanco A, Takahashi H et al (1998) Outcome of endoscopic mucosal resection for early gastric cancer: review of the Japanese literature. Gastrointest Endosc 48:550–554; discussion 554–555

    Article  CAS  PubMed  Google Scholar 

  8. Al Ghossaini N, Lucidarme D, Bulois P (2014) Endoscopic treatment of iatrogenic gastrointestinal perforations: an overview. Dig Liver Dis 46:195–203

    Article  PubMed  Google Scholar 

  9. Fujiya M, Tanaka K, Dokoshi T et al (2015) Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection. Gastrointest Endosc 81:583–595

    Article  PubMed  Google Scholar 

  10. Martínez-Pérez A, de'Angelis N, Brunetti F et al (2017) Laparoscopic vs. open surgery for the treatment of iatrogenic colonoscopic perforations: a systematic review and meta-analysis. World J Emerg Surg 12:8

    Article  PubMed  PubMed Central  Google Scholar 

  11. Polydorou A, Vezakis A, Fragulidis G et al (2011) A tailored approach to the management of perforations following endoscopic retrograde cholangiopancreatography and sphincterotomy. J Gastrointest Surg 15:2211–2217

    Article  PubMed  Google Scholar 

  12. Stavropoulos SN, Modayil R, Friedel D (2015) Closing perforations and postperforation management in endoscopy: esophagus and stomach. Gastrointest Endosc Clin N Am 25:29–45

    Article  PubMed  Google Scholar 

  13. Ge PS, Thompson CC (2020) The use of the overstitch to close perforations and fistulas. Gastrointest Endosc Clin N Am 30:147–161

    Article  PubMed  Google Scholar 

  14. Kantsevoy SV, Bitner M, Hajiyeva G et al (2016) Endoscopic management of colonic perforations: clips versus suturing closure (with videos). Gastrointest Endosc 84:487–493

    Article  PubMed  Google Scholar 

  15. Kantsevoy SV, Bitner M, Davis JM et al (2015) Endoscopic suturing closure of large iatrogenic colonic perforation. Gastrointest Endosc 82:754–755

    Article  PubMed  Google Scholar 

  16. Granata A, Amata M, Martino A et al (2019) Iatrogenic perforation during colonoscopy in the endoscopic suturing era: surgical emergency or endoscopic clinical practice? Endoscopy 51:E366–E367

    Article  PubMed  Google Scholar 

  17. Stavropoulos SN, Modayil R, Friedel D (2015) Current applications of endoscopic suturing. World J Gastrointest Endosc 7:777–789

    Article  PubMed  PubMed Central  Google Scholar 

  18. Modayil R, Friedel D, Stavropoulos SN (2014) Endoscopic suture repair of a large mucosal perforation during peroral endoscopic myotomy for treatment of achalasia. Gastrointest Endosc 80:1169–1170

    Article  PubMed  Google Scholar 

  19. Kumar N, Thompson CC (2014) A novel method for endoscopic perforation management by using abdominal exploration and full-thickness sutured closure. Gastrointest Endosc 80:156–161

    Article  PubMed  PubMed Central  Google Scholar 

  20. Antonino G, Alberto M, Michele A et al (2020) Efficacy and safety of gastric exposed endoscopic full-thickness resection without laparoscopic assistance: a systematic review. Endosc Int Open 8:E1173–E1182

    Article  PubMed  Google Scholar 

  21. Cai MY, Martin Carreras-Presas F, Zhou PH (2018) Endoscopic full-thickness resection for gastrointestinal submucosal tumors. Dig Endosc 30(Suppl 1):17–24

    Article  PubMed  Google Scholar 

  22. Cai M, Zhou P, Lourenço LC et al (2016) Endoscopic Full-thickness Resection (EFTR) for gastrointestinal subepithelial tumors. Gastrointest Endosc Clin N Am 26:283–295

    Article  PubMed  Google Scholar 

  23. Mori H, Kobara H, Nishiyama N et al (2018) Current status and future perspectives of endoscopic full-thickness resection. Dig Endosc 30(Suppl 1):25–31

    Article  PubMed  Google Scholar 

  24. Zhou PH, Yao LQ, Qin XY et al (2011) Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc 25:2926–2931

    Article  PubMed  Google Scholar 

  25. Shi Q, Chen T, Zhong YS et al (2013) Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy 45:329–334

    Article  CAS  PubMed  Google Scholar 

  26. Ye LP, Yu Z, Mao XL et al (2014) Endoscopic full-thickness resection with defect closure using clips and an endoloop for gastric subepithelial tumors arising from the muscularis propria. Surg Endosc 28:1978–1983

    Article  PubMed  Google Scholar 

  27. Guo J, Liu Z, Sun S et al (2015) Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria. Surg Endosc 29:3356–3362

    Article  PubMed  PubMed Central  Google Scholar 

  28. Yang F, Wang S, Sun S et al (2015) Factors associated with endoscopic full-thickness resection of gastric submucosal tumors. Surg Endosc 29:3588–3593

    Article  PubMed  PubMed Central  Google Scholar 

  29. Aslanian HR, Sethi A, Bhutani MS et al (2019) ASGE guideline for endoscopic full-thickness resection and submucosal tunnel endoscopic resection. VideoGIE 4:343–350

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mangiavillano B, Viaggi P, Masci E (2010) Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: a literature review. J Dig Dis 11:12–18

    Article  PubMed  Google Scholar 

  31. Kantsevoy SV (2015) Endoscopic suturing devices. Endoscopic management of gastrointestinal cancer and precancerous conditions. In: Testoni PA, Arcidiacono PG, Mariani A (eds) Endoscopic management of gastrointestinal cancer and precancerous conditions. Edizioni Minerva Medica, Turin

    Google Scholar 

  32. Juzgado D, Sanchez-Yague A (2020) The use of the overstitch beyond bariatric endoscopy: a pictorial description. Gastrointest Endosc Clin N Am 30:173–185

    Article  PubMed  Google Scholar 

  33. Andalib I, Yeoun D, Reddy R et al (2018) Endoscopic resection of gastric gastrointestinal stromal tumors originating from the muscularis propria layer in North America: methods and feasibility data. Surg Endosc 32:1787–1792

    Article  PubMed  Google Scholar 

  34. Azzolini F, Cecinato P, Iori V et al (2015) Endoscopic full-thickness resection for suspected residual rectal neuroendocrine tumor and closure of the defect with a new suturing system. Endoscopy 47(Suppl 1):E556–E557

    PubMed  Google Scholar 

  35. Xu MM, Angeles A, Kahaleh M (2018) Endoscopic full-thickness resection of gastric stromal tumor: one and done. Endoscopy 50:E42–E43

    Article  PubMed  Google Scholar 

  36. Granata A, Bisello M, Cipolletta F et al (2018) Endoscopic wedge gastrectomy of a gastric subepithelial tumor and closure of the gastric wall defect with the overstitch suturing system. Surg Innov 25:542–543

    Article  PubMed  Google Scholar 

  37. Granata A, Amata M, Ligresti D et al (2019) Underwater full-thickness resection of a duodenal bulb gastrointestinal stromal tumor with OverStitch defect repair. Endoscopy 51:E207–E208

    Article  PubMed  Google Scholar 

  38. Dedania B, Mistry T, Buryanek J et al (2018) Endoscopic full-thickness resection of a gastric subepithelial tumor. VideoGIE 3:79–80

    Article  PubMed  PubMed Central  Google Scholar 

  39. Pawlak KM, Raiter A, Kozłowska-Petriczko K et al (2020) Optimal endoscopic resection technique for selected gastric GISTs. The endoscopic suturing system combined with ESD-a new alternative? J Clin Med 9:1776

    Article  PubMed Central  Google Scholar 

  40. Modayil R, Stavropoulos SN (2016) A western perspective on “New NOTES” from POEM to full-thickness resection and beyond. Gastrointest Endosc Clin N Am 26:413–432

    Article  PubMed  Google Scholar 

  41. Kantsevoy SV (2019) Closure methods and devices. Tech Gastrointest Endosc 21(1):33–37

    Article  Google Scholar 

  42. Goto O, Sasaki M, Ishii H et al (2014) A new endoscopic closure method for gastric mucosal defects: feasibility of endoscopic hand suturing in an ex vivo porcine model (with video). Endosc Int Open 2:E111–E116

    Article  PubMed  PubMed Central  Google Scholar 

  43. Kantsevoy SV, Bitner M, Mitrakov AA et al (2014) Endoscopic suturing closure of large mucosal defects after endoscopic submucosal dissection is technically feasible, fast, and eliminates the need for hospitalization (with videos). Gastrointest Endosc 79:503–507

    Article  PubMed  Google Scholar 

  44. Han S, Wani S, Kaltenbach T et al (2019) Endoscopic suturing for closure of endoscopic submucosal dissection defects. VideoGIE 4:310–313

    Article  PubMed  PubMed Central  Google Scholar 

  45. Akimoto T, Goto O, Nishizawa T et al (2017) Endoscopic closure after intraluminal surgery. Dig Endosc 29:547–558

    Article  PubMed  Google Scholar 

  46. Han S, Wani S, Edmundowicz SA et al (2020) Feasibility of endoscopic suturing to prevent adverse events and hospitalization after endoscopic submucosal dissection. Endosc Int Open 8:E1212–E1217

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Digestive Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS – ISMETT, Palermo, Italy

    Antonino Granata, Michele Amato, Alberto Martino & Mario Traina

Authors
  1. Antonino Granata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michele Amato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alberto Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mario Traina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mario Traina .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Gastrointestinal Endoscopy IRCCS, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

    Pier Alberto Testoni

  2. Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan

    Haruhiro Inoue

  3. Department of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA

    Michael B. Wallace

Section Editor information

  1. Gastrointestinal Endoscopy Unit, Vita‐Salute San Raffaele University, Milan, Italy

    Pier Alberto Testoni

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Granata, A., Amato, M., Martino, A., Traina, M. (2022). Full-Thickness Closure of Iatrogenic or Post-Interventional Gastrointestinal Defect by the Use of Flexible Endoluminal Suturing Device. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-56993-8_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-56993-8_27

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56992-1

  • Online ISBN: 978-3-030-56993-8

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation