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Efficacy and safety of a novel closure method Loop9 for mucosal defect after Colorectal Endoscopic submucosal dissection

ABSTRACT: Primary outcome(s): Complete closure rate

DISEASE(S): Colorectal Tumors

PROVIDER: 2724313 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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

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.

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

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Clip on Clip Closure Method (CCCM) for mucosal defect after colorectal endoscopic submucosal dissection: a prospective study

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Underwater reopenable clip closure of mucosal defects after duodenal endoscopic submucosal dissection.

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A prospective study investigating the efficacy and safety of traction-band-assisted endoscopic closure for mucosal defect after colorectal endoscopic submucosal dissection: A multi-center trial (TBEC Trial)

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Clip with line-pulley securing technique with plastic detachable snare for endoscopic submucosal dissection defect closure.

Project description:Video 1Clip with line-pulley securing technique with plastic detachable snare for endoscopic submucosal dissection defect closure.

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Efficacy of line-assisted complete closure of large colorectal mucosal defects after endoscopic submucosal dissection: a randomized controlled trial

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A novel, simple, and dedicated device for endoscopic mucosal defect closure.

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.

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