Step-by-step approach to endoscopic gastroplasty by a novel single-channel endoscopic suturing system.
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ABSTRACT:
SUBMITTER: Lopez-Nava G
PROVIDER: S-EPMC6831913 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Video 1Video demonstration of endoscopic sleeve gastroplasty performed using a novel suture pattern termed the "cable" technique.
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Project description:Multiple reports have demonstrated the efficacy of endoscopic dacryocystorhinostomy (DCR). However the results of the same have varied from centre to centre. Many still regard external DCR as the gold standard. To describe an endoscopic DCR technique which anatomically simulates an external DCR and assess its results. Prospective, nonrandomized and noncomparative interventional case series. Clinical charts of patients with nasolacrimal duct obstruction based on symptomatic, clinical and radiological basis were included in the study. All surgeries were done endonasally using standard operative technique. The modification in the standard technique included creating a wide exposure of the lacrimal sac, incising the sac and the suturing the medial wall of the lacrimal sac with the lateral nasal wall. The same was achieved by using either vascular clips or 5.0 vicryl sutures. Twenty (11 females and 9 males) were included in the study. The average age of the patients was 56.86 years old (range 27-85 years old). The main presenting symptom was epiphora and 1 patient with mucocele. Successful outcome was measured in terms of relief of sympto anatomical patency assessed by sac syringing and nasal endoscopy showing a wide patent lumen. A primary success rate of 95% and ultimate rate of 100% was achieved in the cases with a nasolacrimal duct (NLD) block while an overall success rate of 82.6% was noted when the cases with NLD block and common canalicular block were considered together. Endoscopic DCR can now easily replace external DCR as a standard. It is not only minimally invasive, but has minimal complications and using this technique, we have been able to achieve very high success rates.
| S-EPMC3738795 | biostudies-literature
Project description:Background and aimsThere is growing interest in closure of larger mucosal defects, given the increasing use of endoscopic resection for early GI neoplasia and the advent of submucosal endoscopy, including peroral endoscopic myotomy. Existing closure methods include through-the-scope clips, over-the-scope clips, and over-the-scope suturing. Although over-the-scope clips and over-the-scope suturing allow closure of large defects, both require endoscope removal for device application and may have difficulty in treating lesions in the proximal colon or the small intestine. Hence, a significant gap exists for a through-the-scope device capable of closing larger defects. The novel X-Tack system (Apollo Endosurgery, Austin, Tex, USA) offers through-the-scope suturing (TTSS), which eliminates the need to withdraw the endoscope from the patient before applying therapy.MethodsWe demonstrate the possible indications for endoscopic mucosal adhesion with TTSS through a video case series. We present 5 cases to illustrate the use of TTSS in the closure of a duodenal EMR defect, a cecal EMR defect, mucostomy after esophageal and gastric peroral endoscopic myotomy, and, finally, for primary closure of a gastrogastric fistula.ResultsAll defects were successfully closed with 1 to 2 TTSS systems. There were no postprocedure adverse events, including bleeding or perforation, at a median of 30 (range 14-30) days of follow-up.ConclusionsTTSS is a valuable addition to mucosal closure devices, which allows closure through a gastroscope or a colonoscope, without requiring endoscope removal for device application. Likely applications include larger or more distant defects and those located within tight spaces. Pending further clinical evaluation, important areas for research include assessment of the learning curve, comparative trials with other closure devices, and cost-effectiveness analysis.
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Project description:In the current study, we reported our initial experience of gasless transoral endoscopic thyroidectomy vestibular approach (TOETVA) by novel trocars and a suspension system. Between February 2019 to September 2020, thyroid cancer patients with indicated central lymph node metastasis by imaging examination who had received gasless TOETVA by our designed trocars and suspension system in The First Affiliated Hospital of University of Science and Technology of China were reviewed. A total of 95 thyroid cancer patients that received gasless TOETVA were included in this analysis. Of note, 73 cases underwent one-sided lobectomy and the remaining 22 cases underwent total thyroidectomy. All thyroid cancer patients underwent central lymph node dissection (CND). The average total examined lymph nodes number was 8.55 ± 5.67 per individual. No serious complications occurred during or after the operation besides one patient who had a short-term recurrent laryngeal nerve (RLN) deficit and one patient who had delayed postoperative bleeding. In conclusion, the use of novel trocars and a suspension system can effectively improve the safety and efficacy of TOETVA.
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Project description:Video 1Technical feasibility, safety, and efficacy of a novel endoscopic approach to treating weight regain after open vertical-banded gastroplasty using an endoscopic suturing device.
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