CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E572-E577
DOI: 10.1055/a-1370-9256
Original article

Gastrointestinal defect closure using a novel through-the-scope helix tack and suture device compared to endoscopic clips in a survival porcine model (with video)

Ariosto Hernandez
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
2   Mayo Clinic Developmental Endoscopy Unit, Rochester, Minnesota, United States
,
Neil B. Marya
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Tarek Sawas
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Elizabeth Rajan
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
2   Mayo Clinic Developmental Endoscopy Unit, Rochester, Minnesota, United States
,
Naomi M. Gades
3   Department of Comparative Medicine, Mayo Clinic, Scottsdale, Arizona, United States
,
Louis M. Wong Kee Song
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Barham K. Abu Dayyeh
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Navtej Buttar
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Andrew C. Storm
1   Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota, United States
2   Mayo Clinic Developmental Endoscopy Unit, Rochester, Minnesota, United States
› Author Affiliations

Abstract

Background and aims Endoscopic resections are associated with bleeding and perforation and may be managed with through-the-scope (TTS) clips, over-the-scope clips and endoscopic suturing. The aim of this preclinical study was to compare technical success of closure using a novel TTS tissue helix tack and suture device (X-Tack) to TTS clips in a porcine model.

Materials and methods Four subjects underwent 40 mucosal resections, diameter range 25–50 mm, in the stomach (n = 24) and colon (n = 16). Closures were randomized to X-Tack (n = 24) or clip (n = 16). Animals underwent weekly endoscopic follow-up for 4 weeks.

Results Technical closure with X-Tack was successful in 24 of 24 (100 %) cases and with clips in 13 of 16 cases (81.3 %) (P = 0.0001). One colonic perforation occurred and was successfully managed using X-Tack. The rate of healing was not statistically different between the groups, and all sites healed at 4 weeks including the perforation and were confirmed by histology.

Conclusions Compared to TTS clip, X-Tack is superior for effecting large mucosal defect closure, including durable sealing of full-thickness perforation. There was no difference in rate of healing between devices.



Publication History

Received: 16 September 2020

Accepted: 23 November 2020

Article published online:
12 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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