GIE Senior Associate Editor John R. Saltzman, MD, highlights this article from the February issue: “Initial multicenter experience using a novel endoscopic tack and suture system for challenging GI defect closure and stent fixation (with video)” by Tala Mahmoud, MD, et al.
Large mucosal defects that occur after snare resection, EMR, or ESD can be difficult to close and may cause bleeding or perforation.
This study reports real-world experience closing mucosal defects with a mean size of 37 mm using a recently FDA-approved novel endoscopic tack and suture system in 93 patients from 8 medical centers. Technical success was achieved in 89% of cases with no serious adverse events.
This new device appears to be easier to use than other available devices and is effective at closing large mucosal defects.
The through-the-scope endoscopic tack and suture system represents a new therapeutic option that allows most endoscopists to safely close large mucosal defects.
Applications of the tack and suture device. A, Colonic EMR defect. B, Closure of the colonic EMR defect with tack and suture device. C, Closed EMR defect after deployment of cinch. D, Jejunal fistula. E, Closure of fistula with tack and suture device. F, Closed fistula after deployment of cinch. G, A perforated gastric ulcer. H, Closure of a perforated ulcer with tack and suture device. I, Closed perforated ulcer after deployment of cinch. J, A lumen-apposing metal stent anchored by the tack and suture device for a duodenal stricture. K, Removal of the stent. L, Patent duodenal lumen after removal of the stent.
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