Project description:Video 1Demonstration of the Loop-10 closure technique for unintentional mucosal perforation during re-do esophageal peroral endoscopic myotomy.

| S-EPMC10183484 | biostudies-literature

Endoscopic Closure of Duodenal Perforation with the Over-the-scope-clipping System.

Project description:Endoscopic treatment for superficial non-ampullary duodenal tumors is technically difficult and challenging due to the anatomical characteristics of the duodenum. It is frequently complicated by procedural accidents, such as perforation. Surgical repair has long been the standard treatment for acute iatrogenic gastrointestinal perforation. However, endoscopic closure has recently emerged as an attractive alternative. In the patient presented herein, the over-the-scope-clipping system (OTSC system) was found to be useful for closing a duodenal perforation that had occurred during endoscopic submucosal dissection. For endoscopists who perform endoscopic treatment of the duodenum, endoscopic closure with the OTSC system is considered to be a technique that is necessary to master.

| S-EPMC5140861 | biostudies-literature

Endoscopic closure using an over-the-scope clip for pancreatobiliary endoscopy-related large gastrointestinal perforation (with video).

Project description:Endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) for pancreatobiliary diseases require advanced techniques. We usually use an oblique-viewing endoscope in such procedures. Sometimes, tumor invasion causes gastrointestinal strictures. Crossing a stricture using an oblique-viewing endoscope is more difficult than using a forward-viewing scope. Therefore, the frequency of scope perforation is higher than other endoscopic procedures. Although surgical repair for gastrointestinal perforations caused by endoscopes has been performed, patients with pancreatobiliary diseases are often elderly and in poor general condition; therefore, patients are hesitant to undergo surgical treatments. Recently, the usefulness of over-the-scope clipping (OTSC) as a minimally invasive rescue method has also been reported. In this study, we report cases of successful endoscopic closure using OTSC for gastrointestinal perforations caused by endoscopes in ERCP and EUS-related procedures. After those procedures, all cases showed no abnormalities in blood tests or symptoms, and emergency surgery was successfully avoided. Thus, endoscopic closure using OTSC for pancreatobiliary endoscopy-related gastrointestinal perforations is safe and effective. However, OTSC requires some expertise. A good assessment of defect size and careful insertion of the scope using OTSC attached to the upper esophagus are needed to avoid clip migration or disinsertion and esophageal tears. Therefore, endoscopic closure using OTSC could be the first choice of treatment for pancreatobiliary endoscopy-related gastrointestinal perforations. We should be familiar with its indication and perform it carefully and rapidly.

| S-EPMC8828168 | biostudies-literature

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.

| S-EPMC10928135 | biostudies-literature

Transcanal Endoscopic Versus Microscopic Tympanoplasty: Is There a Difference in Perforation Closure Rates?

Project description:ObjectiveTo compare closure rates of endoscopic and microscopic tympanoplasty (MT) as influenced by perforation size, perforation location, and graft position.Study designRetrospective chart review.SettingTertiary university medical center.PatientsAdult patients who underwent tympanoplasty by a fellowship-trained neurotologist from January 2010 to December 2019, had at least 2 months of follow-up, and had a tympanic perforation with no cholesteatoma before surgery.InterventionsTranscanal endoscopic tympanoplasty (ET) or MT.Main outcome measuresThe primary outcome is postoperative closure of the tympanic membrane perforation as assessed using otomicroscopy at the last follow-up appointment.ResultsTwo-hundred and eleven patients-98 in the transcanal ET group and 113 in the MT group-were identified. Tympanic membrane closure rates were not significantly different between the ET and MT groups (79.6% and 84.1% respectively; P = 0.473), and further multivariable analysis revealed that closure rates for ET relative to MT had an insignificant odds ratio (0.56; P = 0.144). Similar analyses also found no significant difference between the 2 methods in subsets of perforation size (small, large, subtotal/total), perforation location (anterior, posterior, inferior), and graft position (underlay, overlay).ConclusionsET resulted in similar rates of postoperative closure rates compared with the microscopic technique.

| S-EPMC10950148 | biostudies-literature

Endoscopic closure of a large perforation during pneumatic dilation of a sleeve gastrectomy stricture.

Project description: Not available

| S-EPMC6545113 | biostudies-literature

A case of delayed perforation after cold snare polypectomy treated conservatively by endoscopic clip closure.

Project description:We present the case of a 45-year-old man who underwent a screening total colonoscopy and developed delayed perforation after a cold snare polypectomy in the descending colon and sigmoid colon. The patient developed abdominal pain and was referred to our department for further evaluation and treatment. On clinical examination, we noted lower abdominal tenderness, mild rebound pain, and elevated levels of inflammatory markers. Abdominal contrast-enhanced computed tomography confirmed the presence of free air in the abdomen. Since there were no signs of peritoneal inflammation and the vital signs were stable, we planned to perform endoscopic clip closure of the perforated area. The patient's symptoms improved with conservative management thereafter, including fasting, fluid replacement, and antibiotic administration. The patient was discharged on the 6th hospital day. In this case report, we discuss the usefulness of endoscopic clip closure in managing delayed perforation.

| S-EPMC10589457 | biostudies-literature

Laparoscopic endoloop technique - A novel approach of managing iatrogenic caecal perforation and literature review.

Project description:IntroductionAn iatrogenic caecal perforation is rare, but a serious complication associated with significant morbidity and mortality. We present a 4min and 50s video on a new improvisation undertaken during laparoscopic management of post-polypectomy caecal perforation.Presentation of caseOur patient presented with an acute abdomen following endoscopic polypectomy. At surgery, the site of caecal perforation was close to the appendicular base with devitalization tissue, secondary to diathermy usage. The hallmark of safety within this novel technique included fresh healthy tissue margins within the endoloop (detachable snare ligation) and ensuring no ischemic tissue was gathered. Complete freeing of the appendix and meso-appendicular base was required and securing three endoloops proximal to the site of perforation. The post-operative course was uneventful.DiscussionThe World Society of Emergency Surgery (WSES) 2013 guidelines suggested an early laparoscopic approach is a safe and effective treatment for colonoscopy-related colonic perforation. There are no national guidelines and the management is dictated by the clinical condition of the patient, co-morbidity, size and site of perforation as well as the scale of bowel preparation, and surgical experience.ConclusionThe endoloop technique described, undertaken during a laparoscopy is a novel approach. It is a simple and effective method, reminding clinicians to adapt techniques when necessary. Nevertheless, it is only limited to perforations around the appendicular base.

| S-EPMC4392367 | biostudies-literature

Endoscopic closure of esophageal, gastric, jejunal, and rectopelvic fistulas with cardiac septal occluder devices: a case series.

Project description:Background and aimsTreating GI fistulas and anastomotic leaks is a challenge. Traditionally, these adverse events have been treated with conservative measures or surgical interventions, both of which have been associated with high rates of morbidity. Although endoscopic techniques are available and commonly minimally invasive, their success can be variable and oftentimes require repeat interventions. Cardiac septal occluder (CSO) devices have emerged as an alternative for managing these complex GI fistulas and anastomotic leaks after the more conservative endoscopic options fail.MethodsBefore the introduction of the CSO device into the body, a CSO delivery system must first be created. After integrating this system with an endoscope, argon plasma coagulation is used on each of the fistulas, and the CSOs are then deployed under fluoroscopy.CasesWe present 4 cases of CSO device placement throughout the GI tract: in the esophagus, jejunum, stomach, and rectosigmoid colon. Each of these cases presents unique challenges in maneuvering the anatomy, ensuring the CSOs fully occlude the fistulas, and are successful in causing tissue in-growth postplacement.ConclusionsThis study presents a case series of 4 successful closures of GI fistulas using CSO devices after the failure of more conservative therapies. Each of these cases takes place in a different part of the GI tract-the esophagus, stomach, small intestines, and large intestines-indicating the broad application of CSO devices. CSOs offer a promising alternative for managing complex GI fistulas and postsurgical anastomotic leaks endoscopically throughout the entire GI tract.

| S-EPMC11853373 | biostudies-literature

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