Case studyEndoscopic management of GI perforations with a new over-the-scope clip device (with videos)
Section snippets
Over-the-scope clip device
The OTSC system is mounted onto the tip of a high-definition gastroscope (Olympus GIF-H180; diameter of 9.8 mm; working channel of 2.8 mm; Olympus, Tokyo, Japan) in the same manner as a band ligator device. In this study we used the “traumatic” version of OTSC, which has pointed teeth (10.5-12.0 mm). The clip is preloaded into the applicator cap in an open state. The OTSC consists of a shape-memory nitinol alloy, which returns to its initial shape when it is released from the applicator,
Results
Seven of 10 patients were male (median age 58.5 years, range 27-82 years). Patient characteristics and outcomes are summarized in Table 1.
Discussion
In the past, the treatment of GI leaks resulting from perforations, fistulas, or anastomotic dehiscence was primarily surgical. Surgical intervention for large-bowel perforation has a mortality rate of up to 8.6%.12 Emergency surgery for perforated gastroduodenal ulcers has a mortality rate ranging from 5% to 30%.13, 14 The advancement of endotherapy in the GI tract requires techniques for safe and effective control of complications. Through-the-scope clips have been used in some clinical
Disclosure
All authors disclosed no financial relationships relevant to this publication.
Acknowledgment
The authors are grateful to Deborah A. Fisher, MD, MHS, Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, for her assistance in revising the manuscript.
References (22)
- et al.
Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity
Gastrointest Endosc
(2004) - et al.
A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers
Gastrointest Endosc
(2003) - et al.
Endoclips for GI endoscopy
Gastrointest Endosc
(2004) - et al.
Prophylactic clip application does not decrease delayed bleeding after colonoscopic polypectomy
Gastrointest Endosc
(2003) - et al.
A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences
Gastrointest Endosc
(2007) - et al.
Clinical experience with a new endoscopic over-the-scope clip system for use in the GI tract
Dig Liver Dis
(2009) - et al.
Successful endoscopic management of a perforated gastric dysplastic lesion after endoscopic mucosal resection
Gastrointest Endosc
(2000) - et al.
Hemoclip repair of a sphincterotomy-induced duodenal perforation
Gastrointest Endosc
(2000) - et al.
Endoscopic repair by clipping of iatrogenic colonic perforation
Gastrointest Endosc
(1997) - et al.
Feasibility study for secure closure of natural orifice transluminal endoscopic surgery gastrotomies by using over-the-scope clips
Gastrointest Endosc
(2008)
In vivo assessment of gastrotomy closure with over-the-scope clips in an experimental model for varicocelectomy (with video)
Gastrointest Endosc
Cited by (151)
Management of esophagogastric fistula caused by adjustable gastric band erosion: A case report and literature review
2023, Obesity Research and Clinical PracticeEndoscopic Therapy for Fistulas and Abscesses in Crohn's Disease
2022, Gastrointestinal Endoscopy Clinics of North AmericaA newly designed over-the-scope-clip device to prevent fully covered metal stents migration: A pilot study
2020, Techniques and Innovations in Gastrointestinal EndoscopyUse of the Over the Scope Clip to Close Perforations and Fistulas
2020, Gastrointestinal Endoscopy Clinics of North AmericaEndoscopic management of iatrogenic gastrointestinal perforations
2019, Laparoscopic, Endoscopic, and Robotic SurgeryCitation Excerpt :Over the scope clip (OTSC) system is an ideal alternative of surgery for large IP. It was first approved by the Food and Drug Administration of the United States in 2010 for endoscopic gastrointestinal wall closure and hemostatsis.45 OTSC is made of nitinol alloy and equipped at the distal end of the endoscope with a transparent cap.
Endoscopic closure of gastrointestinal perforations and fistulas using the Ovesco Over-The-Scope Clip system at a tertiary care hospital center
2019, Revista de Gastroenterologia de Mexico