Closure of mucosal defect with a micro-ring technique: simple, cheap, and effective.
Ontology highlight
ABSTRACT:
SUBMITTER: Quarta Colosso BM
PROVIDER: S-EPMC7004892 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Publications
Closure of mucosal defect with a micro-ring technique: simple, cheap, and effective.
Quarta Colosso Bianca Maria BM Inoue Haruhiro H
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20200130 2
Similar Datasets
Project description:ObjectivesEndoscopic submucosal dissection (ESD) has become popular, but complications such as postoperative bleeding remain an issue. Although some methods of closing a mucosal defect with a snare and clips have been reported to be effective and safe, the snare is not a dedicated device, and the procedure is difficult and time-consuming. We aimed to find an alternative method for defect closure after ESD by developing a dedicated device.MethodsWe have improved five prototypes. The load on the stopper when starting to tighten and loosen a loop and the maximum load on the stopper and the movement distance of the thread when sliding the stopper were measured five times for each prototype. With the 5th prototype, we finalized the design and named it FLEXLOOP. Additionally, the material and shape of the outer tube were improved. Then, the usability of FLEXLOOP was evaluated in pigs. The operation time for closing mucosal defects with the snare or FLEXLOOP was measured five times.ResultsWe made FLEXLOOP, which had a lower load when sliding and a higher load when loosening than the snare. The improvement of the outer tube significantly reduced the load on the sheath when sliding it. We confirmed the feasibility of mucosal defect closure with FLEXLOOP in pigs. The median operation time was 563 s (range 340-679 s) with the snare and 355 s (range 303-455 s) with FLEXLOOP (p = 0.047).ConclusionsFLEXLOOP can be a promising option for defect closure after ESD.
| S-EPMC9302268 | biostudies-literature
Project description:Video 1Rubber band-assisted closure of a mucosal defect after duodenal EMR.
| S-EPMC8573376 | biostudies-literature
Project description:ObjectiveTranscatheter closure of atrial septal defect (ASD) has become an alternative treatment to surgical repair. One of the challenges is the prolapse of the left atrial disc during the procedure. Many techniques have been developed to prevent the prolapse but not reduce it. In this study, we present a novel technique, termed push back technique, that help reduce the prolapsed device.MethodsWe enrolled 24 patients (8 males, 16 females) between May 2008 and January 2023 who underwent the push back technique during transcatheter closure of ASD in Taichung Veterans General Hospital. We recorded the hemodynamic data, success rate and complications including device embolization/migration, valvular regurgitation, pericardial effusion, and residual shunt.ResultsThe median age was 6.3 years (1.2-70.5 years) and the median weight was 19.1 kg (7.8-90 kg). Fifteen (62.5%) patients had mild pulmonary hypertension. The median Qp/Qs was 2.54 (1.5-8.8). The median ASD stretched size was 21.2 mm (7.7-35.3 mm). The median device size was 22 mm (8-40 mm). The median fluoroscopy time was 14 min (5-23 min) and median procedure time was 47 min (25-78 min). The push back technique successfully reduced the prolapsed device in 21 (87.5%) patients. There was no complication in all patients.ConclusionWe present a novel push back technique that can successfully reduce the prolapsed device in 87.5% (21/24) patients without complications. It is feasible, safe and effective.
| S-EPMC10227603 | biostudies-literature
Project description:This SuperSeries is composed of the SubSeries listed below.
2021-02-25 | GSE167456 | GEO
Project description:BackgroundLarge artificial gastric mucosal defects are always left unclosed for natural healing due to technique difficulties in closure. This study aims to evaluate the feasibility and safety of a new Twin-grasper Assisted Mucosal Inverted Closure (TAMIC) technique in closing large artificial gastric mucosal defects.MethodsEndoscopic submucosal dissection (ESD) was performed in fifteen pigs to create large gastric mucosal defects. The mucosal defects were then either left unclosed or closed with metallic clips using TAMIC technique. Successful closure rate and the wound outcomes were assessed.ResultsTwo mucosal defects with size of about 4.0 cm were left unclosed and healed two months after surgery. Thirteen large gastric mucosal defects were created by ESD with a medium size of 5.9 cm and were successfully closed with the TAMIC technique (100%), even in a mucosal defect with a width up to 8.5 cm. The mean closure time was 59.0 min. Wounds in eight stomachs remained completely closed 1 week after surgery (61.5%), while closure in the other five stomachs had partial wound dehiscence (38.5%). Four weeks later, all the closed defects healed well and 61.5% of the wounds still remained completely closed during healing. There was no delayed perforation or bleeding after surgery. In addition, there was less granulation in the submucosal layer of the closed wound sites than those under natural healing.ConclusionsThe present study suggests that TAMIC is feasible and safe in closing large artificial gastric mucosal defects and could improve mucosal recovery compared to natural healing process.
| S-EPMC10776692 | biostudies-literature
Project description:Background and study aims: Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for gastrointestinal lesions. It carries potential risks such as bleeding and perforation. This meta-analysis was conducted to assess the safety, effectiveness, and feasibility of endoscopic suturing, a promising technique for closing mucosal defects post-ESD. Methods: We reviewed several databases, including MEDLINE/PubMed, Cochrane Library, Web of Science, and Embase up to May 1,2023. We aimed at identifying original studies that provided insightful data on the use of endoscopic suturing in reducing complications post-ESD. Results: In our study, we evaluated 426 publications and included 10 studies involving a total of 284 patients. The pooled technical success rate of endoscopic suturing was 92.6% (95% confidence interval [CI] 0.88-0.96). The pooled rate for sustained closure of mucosal defects post-endoscopic submucosal dissection (ESD) was estimated to be 80.7% (95% CI 0.71-0.88). The pooled mean time required to perform the endoscopic suturing procedure was calculated to be 31.11 minutes (95% CI 16.01-46.21). Among the studies reviewed for the incidence of delayed perforation post-ESD, a singular event of perforation was documented, suggesting a minimal occurrence. The overall rate of delayed bleeding was 5.3% (95% CI 0.30-0.10). Within the subset of patients using antithrombotic drugs, our subgroup analysis identified a delayed bleeding event rate of 6.7% (95% CI 0.02-0.25). Conclusions: Our results underscore the potential of endoscopic suturing as a viable and efficient technique in managing mucosal defects following ESD, highlighting the need for further large, prospective research to corroborate these findings and concentrate on establishing standard methodologies.
| S-EPMC11469170 | biostudies-literature
Project description:IntroductionClosure of mucosal defects after duodenal endoscopic submucosal dissection (ESD) is important to prevent postoperative adverse events. Previously, we devised an underwater reopenable-clip closure method for effective closure of mucosal defects under endoscopic guidance within the field of view. Recently, the usefulness of a method using a clip with a line passing through an accessory channel to close a mucosal defect has been reported. We also described a reopenable-clip over the line method (ROLM) to completely close margin and the muscular layers of mucosal defects using a clip line.Case reportOur patient was a 70-year-old woman with a 40-mm duodenal tumor in the descending portion of the duodenum. The lesion was completely resected using ESD . In the result, the mucosal defect size was approximately 50 mm, representing about 3/4 of the duodenal circumference. A clip-line closure was performed using ROLM to close the mucosal defect's margins completely. An additional clip was applied to close the mucosal defect after ESD completely. Subsequently, the line was fixed with a modified locking-clip technique, closed, and cut with endoscopic scissors. The patient was discharged without any adverse events 9 days after the duodenal ESD.DiscussionMucosal defect closure after duodenal ESD using ROLM is a novel method that can reliably close mucosal defects.
| S-EPMC8264231 | biostudies-literature
Project description:Video 1Clip with line-pulley securing technique with plastic detachable snare for endoscopic submucosal dissection defect closure.
| S-EPMC10928135 | biostudies-literature
Project description: Not available
| S-EPMC9992627 | biostudies-literature