Endoclip

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PURPOSE: To review the literature and identify the most economical techniques for laparoscopic appendicectomy (LA) that do not compromise on patient care. METHODS: We performed a search of the Cochrane Library, PubMed, EMBASE and Google Scholar for papers published between January 2001 and January 2021. The outcomes of the included studies were then grouped by theme of cost analysis, with the main areas of focus being the use of disposable equipment, appendiceal stump closure, and retrieval of the appendix...

BACKGROUND: Conventional endoscopic papillectomy (ESP) for ampullary adenoma is performed as a hybrid endoscopy and fluoroscopy guided procedure. In this study, we report our preliminary experience of non-radiation ESP. METHODS: The present method includes endoscopic snare resection, non-radiation endoscopic biliary and pancreatic stenting and endoclipping. Data from ten patients who underwent non-radiation ESP due to ampullary adenoma were collected. Procedure details, adverse events and follow-up were analyzed...

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Tuberculosis is a primary lung disease that can spread to the lymph nodes, vertebrae, and gastrointestinal tract. The esophagus can be affected by mediastinal lymphadenitis, mostly in immunocompromised patients, leading to the formation of esophagomediastinal fistulas. They can cause dysphagia, pleuritic chest pain, and choking coughs from recurrent aspiration. The treatment is surgery but endoscopic interventions using over-the-scope endoclips, stents, medical adhesives, and sutures are successful alternatives...

Repository-esophageal fistula (REF) in children includes congenital or acquired tracheoesophageal fistula (TEF) and pleuro-esophageal fistula (PEF). TEF is a well-known congenital anomaly that is managed surgically. Recurrent tracheoesophageal fistula (rTEF) occurring after surgical repair of TEF is not an uncommon complication and most of the time requires repeat surgery. The aim of this paper is to report the outcomes of endoscopic closure of REF in children in Oman. This is a retrospective case series describing the endoscopic closure of REF in children in the Royal Hospital (RH), Oman...

Background and Objectives: While laparoscopic appendectomy is standardized, techniques for appendiceal stump closure and mesoappendix division remain variable. Novel vessel sealing techniques are increasingly utilized ubiquitously. We sought to systematically summarize all relevant data and to define the current evidence on the safety and utility of energy devices for clipless−sutureless laparoscopic appendectomy in this systematic review and meta-analysis. Materials and Methods: This review was conducted following the PRISMA guidelines...

Acute appendicitis is one of the most commonly encountered surgical emergencies worldwide. The laparoscopic approach for managing acute appendicitis is gaining popularity over open appendicectomy in the current surgical practice. The advantages of laparoscopic appendectomy are early recovery, fewer wound complications, less pain and better cosmesis. One of the most critical steps in laparoscopic appendicectomy is a secure appendicular stump closure. Life-threatening postoperative complications are often encountered following the breakdown of appendicular stump closure...

BACKGROUND: Conventional endoscopic papillectomy (EP) is safe and effective for the treatment of small papilla adenoma to even large laterally spreading tumors of duodenum lesions. As reported by some existing studies, temporarily placing a prophylactic stent in the pancreatic and bile duct can lower the risk of this perioperative complication. AIM: To evaluate the usefulness, convenience, safety, and short-term results of a novel autorelease bile duct supporter after EP procedure, especially the effectiveness in preventing EP...

A 28-year-old woman, with a history of liver transplantation with Roux-en-Y hepaticjejunostomy, was admitted for melena and severe anemia. Bidirectional endoscopy was normal. Capsule endoscopy demonstrated fresh blood in the efferent limb downstream of the jejuno-jejunostomy. Anterograde double-balloon enteroscopy (DBE) showed an adherent clot with a visible vessel oozing next to the hepaticojejunostomy. Bleeding was treated firstly with argon plasma coagulation and endoclips and further treated with dual emission laser, achieving complete hemostasis...

Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retrospective data on diverticular bleeding between 2011 and 2016 was reviewed. Those with an active bleeding source confirmed by colonoscopy (excluding non-bleeding vessels and adherent clots) who received either HSE-C or clipping were evaluated...

Background and Objectives: The multiple endoclip retraction technique (MERT) was developed based on our experience with suturing renal parenchyma in laparoscopic partial nephrectomy. In this study we prospectively evaluated the one-year results of cases treated by transperitoneal laparoscopic Burch with the MERT. Methods: The patients were evaluated with stress test, one-hour pad test, and were requested to complete the International Continence Society Incontinence Questionnaire short form (ICIQ-SF) in the postoperative period...

OBJECTIVE: This study is a prospective study to explore the therapeutic effect of endoscopic purse-string sutures in high-risk peptic ulcer hemorrhage. PATIENTS AND METHODS: We prospectively collected and analyzed data from July 2018 to December 2020 from patients in Jinshan hospital, Fudan University, who underwent emergency endoscopy for acute severe high-risk non-variceal upper gastrointestinal hemorrhage (NVUGIB) and were treated with endoscopic purse-string sutures...

Serious iatrogenic bowel injuries during screening colonoscopy are rare events. If a perforation is detected during colonoscopy, endoscopic therapy can be attempted depending on the size and type as well as local endoscopic experience. We report the case of a 54-year-old female patient who was treated by endoscopic vacuum therapy (EVT) for a rectal perforation she had suffered during an outpatient screening colonoscopy. Two hours after the complication, an emergency endoscopy was performed. A perforation of the lower third of the rectum with a longitudinal diameter of 4 cm and a depth of 2...

A 73-year-old female underwent open mitral valve replacement with transesophageal echocardiography (TEE) guidance. She developed upper gastrointestinal bleeding postoperatively and was found on upper endoscopy to have a bleeding site at the gastric cardia with the appearance of focal trauma and a possible puncture site. A submucosal bluish protrusion was seen throughout the esophagus with a mucosal flap at the proximal esophagus. As a unifying diagnosis, it was suspected that the intraoperative TEE probe caused a submucosal dissection with point of entry at the proximal esophagus, running the entire length of the esophagus and exiting at the gastric cardia, giving rise to a clinical upper gastrointestinal bleed...

BACKGROUND: Complete closure of gastric wall defects is critical following endoscopic full-thickness resection (EFTR). The aim of this study was to evaluate the efficacy, safety, and clinical outcome of a new endoscopic method: closing while dissecting. METHODS: Twenty-seven patients who underwent EFTR were retrospectively analyzed between January 2020 and March 2021. Gastric defects resulting from EFTR were closed using the "interrupted-close during dissection" technique with endoclips...

BACKGROUND AND AIMS: The X-Tack endoscopic HeliX tacking system (Apollo Endosurgery, Austin, Tex, USA) has recently been approved by the Food and Drug Administration and is slowly gaining popularity for the closure of large tissue defects. Despite its increasing use, outcome data of using the X-Tack system for mucosal defect closure after endoscopic resection (ER) are limited. Here, we report the follow-up outcomes of a series of cases that underwent ER and mucosal closure aided by the HeliX tacking system...

Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases...

A surgical endoclip in the cystic pedicle rarely migrates to the duodenum and is considered a rare complication of laparoscopic cholecystectomy. Duodenal adenocarcinoma endoscopically mimicking a foreign body granuloma in the background of postcholecystectomy endoclip migration has never been reported before. A 53-year-old Indian male presented with progressive weakness and melena for the last three months. He underwent laparoscopic cholecystectomy a year ago with an uneventful clinical course and post-operative recovery...

Video 1We performed endoscopic submucosal dissection with the patient under conscious sedation. After making markings around the lesion, we incised the mucosa from the oral side of the ampullary lesion and dissected the submucosal layer using a Clutch Cutter. We created 2 submucosal tunnels to identify the dissection line of the ampulla. After completion of the tunnels, we performed a mucosal incision circumferentially and dissected the submucosal layer except the ampulla. Subsequently, we removed the ampulla directly above the muscle layer of the duodenum using the Clutch Cutter...