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Step-by-step instruction: using an endoscopic tack and suture device for gastrointestinal defect closure.

ABSTRACT: Video 1Step-by-step demonstration of the assembly and setup of the tack and suture device during closure of a mucosal defect in a patient with a poorly healing postendoscopic mucosal resection ulcer.

SUBMITTER: Hernandez-Lara A

PROVIDER: S-EPMC8187141 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Endoscopic full-thickness resection with through-the-scope suture closure for gastrointestinal stromal tumor.

Project description:Video 1Endoscopic full-thickness resection with through-the-scope suture closure for gastrointestinal stromal tumor.

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Contemporary Hip Capsular Management and Closure Using a Suture Passing Device.

Project description:Before comprehensive correction of femoroacetabular impingement syndrome, capsular management must be thoughtfully considered to ensure both adequate visualization for bony resection and prevention of iatrogenic microinstability. A number of biomechanical and clinical studies have shown the importance of performing comprehensive capsular closure to restore native hip biomechanical kinematics. The purpose of this Technical Note is to describe the technique of using a suture passing device for capsular plication by a fellowship-trained hip arthroscopist at a large-volume academic center.

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Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture.

Project description:The quad tendon has increasingly became a very common option for anterior cruciate ligament reconstruction. Minimally invasive approaches are one of the many advantages to the quad tendon graft. One of the issues with a small incision is assuring appropriate proximal closure. In this technique, we use the arthroscope to view proximally and a Scorpion (Arthrex) device to close our proximal quad harvest. We also describe the updated preparation of the quad tendon with FiberTag TightRope (Arthrex) and FiberTag ABS (Arthrex). These implants have FiberTag incorporated to the suspensory devices that creates a stable construct that is faster to incorporate into the quad with the slotted clamp. Together, these updates to the preparation and harvest should make the construct more reproducible and decrease donor-site morbidity respectively.

| S-EPMC7823142 | biostudies-literature

Arthroscopic In Situ Biceps Tenodesis Using a Double Loop-and-Tack Knotless Suture Anchor

Project description:The long head biceps tendon is a common culprit of anterior shoulder pain and dysfunction that can be surgically treated with tenotomy or tenodesis. Many techniques exist for tenodesis. This article submits an arthroscopic technique using two loop-and-tack sutures and a knotless suture anchor to tenodese the long head biceps tendon in the proximal bicipital groove in situ. The advantage of this technique is that it maintains the biceps in its native position by performing tenodesis before tenotomy. Most other techniques attempt to restore native position of the biceps through approximation. The transverse humeral ligament is also released to decompress the bicipital groove. This technique can be used to treat isolated biceps pathology or combined with rotator cuff and labral procedures. Technique Video Video 1 Arthroscopic in situ biceps tenodesis using a double loop-and-tack knotless suture anchor. This video uses a case example of a left shoulder in lateral decubitus position viewed from the posterior portal. The following steps are included: 1) positioning and arthroscopic evaluation, 2) localization of the long head biceps tendon, 3) implementation of loop-and-tack sutures, and 5) in situ biceps tenodesis followed by tenotomy.

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Closure of Iatrogenic Atrial Septal Defect After Placement of Left Atrial Appendage Closure Device.

Project description:An 86-year-old woman experienced hypoxia with right-to-left flow across an iatrogenic atrial septal defect after deployment of a left atrial appendage closure device. Emergent closure of the defect was performed with an atrial septal occluder device with resolution of hypoxia. (Level of Difficulty: Intermediate.).

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Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo-Endothelialization.

Project description:Background Current guidelines recommend at least 6 months of antithrombotic therapy and antibiotic prophylaxis after septal-occluding device deployment in transcatheter closure of atrial septal defect. It has been estimated that it takes ≈6 months for complete neo-endothelialization; however, neo-endothelialization has not previously been assessed in vivo in humans. Methods and Results The neointimal coverage of septal occluder devices was evaluated 6 months after implantation in 15 patients by angioscopy from the right atrium. Each occluder surface was divided into 9 areas; the levels of endothelialization in each area were semiquantitatively assessed by 4-point grades. Device neo-endothelialization was sufficient in two thirds of patients, but insufficient in one third. In the comparison between patients with sufficiently endothelialized devices of average grade score ≥2 (good endothelialization group, n=10) and those with poorly endothelialized devices of average grade score <2 (poor endothelialization group, n=5), those in the poor endothelialization group had larger devices deployed (27.0 mm [25.0-31.5 mm] versus 17.0 mm [15.6-22.5 mm], respectively) and progressive right heart dilatation. The endothelialization was poorer around the central areas. Moreover, the prevalence of thrombus formation on the devices was higher in the poorly endothelialized areas than in the sufficiently endothelialized areas (Grade 0, 94.1%; Grade 1, 63.2%; Grade 2, 0%; Grade 3, 1.6%). Conclusions Neo-endothelialization on the closure devices varied 6 months after implantation. Notably, poor endothelialization and thrombus attachment were observed around the central areas and on the larger devices.

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Mucosal defect closure after duodenal endoscopic submucosal dissection using the reopenable-clip over the line method.

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Mobile vegetations on a poorly endothelialized atrial septal defect closure device.

Project description: Not available

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Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure.

Project description:Video 1Hybrid endoscopic submucosal dissection with novel helix tacking system for defect closure.

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A novel one-step lens cleaning device using air and water flow for endoscopic surgery.

Project description:In a surgical operation requiring endoscopy, it is essential to obtain a clear endoscopic view. However, it is often disturbed by the contamination on the lens during the surgery. No device can clean the lens surface simply and completely. Many surgeons are hampered by the impaired view and the distraction by the repeated cleaning of the lens. Therefore, we developed a novel endoscope cleaning device to address this problem. The device was made of 3D-printed rubber-like plastic. It contains a syringe filled with saline and an aspiration system. It would be used intraoperatively to wash the lens surface in a few seconds with rapid flow of water and air. The cleaning ability of the device was evaluated using mayonnaise with adenosine triphosphate (ATP) as a model contaminant. The gauze-wiping maneuver was selected as control. After each maneuver, the clarity of the endoscopic view was evaluated, and residual contaminants were assessed quantitatively with ATP assay. The cleaning device obtained a crisp and clear view and eliminated the contaminant on the lens every time after a single cleaning maneuver. The gauze-wiping maneuver required for the lens to be wiped at least three times to obtain a clear view, and even then, some contaminants remained. Repeated contamination and cleaning using gauze led to accumulation of contaminants on the lens, which resulted in difficulty in cleaning the lens as the operation proceeded. The cleaning device did not show such accumulation. Our novel cleaning device with air and water flow has been shown to wash out the lens contaminants completely and immediately in a simple manner. It is expected to improve the safety and cost-effectiveness of endoscopic surgery.

| S-EPMC6051665 | biostudies-literature

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