Feasibility of a new endoscopic suturing device: a first Western experience.


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
06 Aug 2024
Historique:
received: 14 02 2024
revised: 23 06 2024
accepted: 01 08 2024
medline: 9 8 2024
pubmed: 9 8 2024
entrez: 8 8 2024
Statut: aheadofprint

Résumé

Endoscopic hand suturing (EHS) is a new technique for the closure of mucosal defects in the gastrointestinal tract. While this method was tested for wound closure after endoscopic submucosal dissection (ESD) in Japan, a feasibility test in a Western setting is lacking. In this study we present our first experience with EHS for different indications and in different anatomical locations. Technical success of EHS as well as suturing speed were retrospectively determined for all available EHS cases in our center. Technical success was defined as complete closure of the mucosal defect or visually tight fixation of the target. 19 EHS procedures were performed in 17 patients (mean age 54.9 years, standard error of the mean [SEM] 4.2 years, male 53% [n=9]). Technical success was achieved in 78.9% (n=15). Total EHS operation time was 40.0 min (SEM 3.1 min) with 3.3 min (SEM 0.2 min) per single stitch. In a constant team of endoscopist and assistant mean stitch times declined significantly from the first four to the second four of eight cases (4.0 min [SEM 0.6] vs. 2.3 min [SEM 0.2], p=0.02). EHS was technically feasible and applicable in different anatomical locations. Further studies may elucidate a possible effect on complication rates of endoscopic resections.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Endoscopic hand suturing (EHS) is a new technique for the closure of mucosal defects in the gastrointestinal tract. While this method was tested for wound closure after endoscopic submucosal dissection (ESD) in Japan, a feasibility test in a Western setting is lacking. In this study we present our first experience with EHS for different indications and in different anatomical locations.
METHODS METHODS
Technical success of EHS as well as suturing speed were retrospectively determined for all available EHS cases in our center. Technical success was defined as complete closure of the mucosal defect or visually tight fixation of the target.
RESULTS RESULTS
19 EHS procedures were performed in 17 patients (mean age 54.9 years, standard error of the mean [SEM] 4.2 years, male 53% [n=9]). Technical success was achieved in 78.9% (n=15). Total EHS operation time was 40.0 min (SEM 3.1 min) with 3.3 min (SEM 0.2 min) per single stitch. In a constant team of endoscopist and assistant mean stitch times declined significantly from the first four to the second four of eight cases (4.0 min [SEM 0.6] vs. 2.3 min [SEM 0.2], p=0.02).
CONCLUSIONS CONCLUSIONS
EHS was technically feasible and applicable in different anatomical locations. Further studies may elucidate a possible effect on complication rates of endoscopic resections.

Identifiants

pubmed: 39117238
pii: S0016-5107(24)03408-4
doi: 10.1016/j.gie.2024.08.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Markus W Scheppach (MW)

Internal Medicine III - Gastroenterology, University Hospital of Augsburg, Augsburg, Germany. Electronic address: markus.scheppach@uk-augsburg.de.

Sandra Nagl (S)

Internal Medicine III - Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.

Anna Muzalyova (A)

Institute for Digital Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.

Johanna Classen (J)

Internal Medicine III - Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.

Helmut Messmann (H)

Internal Medicine III - Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.

Alanna Ebigbo (A)

Internal Medicine III - Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.

Classifications MeSH