Comparison of monopolar hemostatic forceps with soft coagulation versus hemostatic clip for peptic ulcer bleeding

Post written by Bilal Toka, MD, from the Department of Gastroenterology, Sakarya University Faculty of Medicine, Sakarya, Turkey.

Mechanical and thermal endoscopic methods are the most commonly used methods for the treatment of gastrointestinal (GI) bleeding. The hemostatic clip is one of the most common mechanical methods used. Monopolar hemostatic forceps soft coagulation (MHFSC) is a safe thermal method and has a low risk of perforation, and a limited number of studies reported that it could also be effective in the treatment of peptic ulcer bleeding. We aimed to compare these 2 methods in the treatment of peptic ulcer-related upper GI bleeding.

Despite technological advances in endoscopic methods, GI bleeding still has a high mortality and morbidity. Therefore, we think that new techniques should be improved in the treatment of GI bleeding. To the best of our knowledge, MHFSC is used in the treatment of GI bleeding in some countries such as Korea and Japan and is rarely preferred in western countries. We aimed to compare the MHFSC method, which we use frequently in the treatment of GI bleeding, with the hemostatic clip method, which is frequently used worldwide. We wanted to contribute to the literature on the treatment of GI bleeding by demonstrating the efficacy of this relatively new treatment modality.

In the treatment of GI bleeding, MHFSC is a relatively new thermal treatment method, that automatically works at a lower voltage compared with other thermal methods.  Our  study showed that MHFSC was associated with a higher hemostasis success rate, lower recurrent bleeding rate, and shorter duration of endoscopic treatment compared with the HC method. We also showed that MHFSC was an effective treatment method when HCs failed to achieve initial hemostasis or the patient developed recurrent bleeding. MHFSC was determined to be a safe treatment method too. In our study, there were no procedure-related major adverse events such as perforation in patients treated with MHFSC.

We think that MHFSC is a good alternative treatment method for the treatment of peptic ulcer bleeding which can not be achieved with other endoscopic methods. However, study was conducted at a gastroenterology reference center, and the results need to be confirmed by less-experienced endoscopists.


Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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