Endoscopic closure of gastrointestinal perforations and fistulas using the Ovesco Over-The-Scope Clip system at a tertiary care hospital center

Mosquera-Klinger, Gabriel; Torres-Rincón, Ricardo Andrés; Jaime-Carvajal, J.

doi:10.1016/j.rgmxen.2018.10.005

Cited by 8 publications

(8 citation statements)

References 9 publications

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“…Endoscopic resection of luminal GI neoplasms has traditionally been limited to the mucosa and submucosa due to the lack of adequate closure techniques. The introduction of the OTSC and the research on natural orifice transluminal endoscopic surgery (NOTES) paved the way for transmural endoscopic interventions ( 14 , 24 ). In 2014, two groups separately reported the first clinical cases of EFTR using a OTSC device ( 25 , 26 ).…”

Section: Endoscopic Full-thickness Resectionmentioning

confidence: 99%

See 1 more Smart Citation

Colon Sparing Endoscopic Full-Thickness Resection for Advanced Colorectal Lesions: Is It Time for Global Adoption?

Ding

Song

et al. 2022

Front. Oncol.

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The majority of colon lesions are <10 mm in size and are easily resected by endoscopists with appropriate basic training. Lesions ≥10 mm in size are difficult to remove technically and are associated with higher rates of incomplete resection. Currently, the main endoscopic approaches include endoscopic mucosal resection (EMR) for lesions without submucosal invasion, and endoscopic submucosal dissection (ESD) for relatively larger lesions involving the superficial submucosal layer. Both of these approaches have limitations, EMR cannot reliably ensure complete resection for larger tumors and recurrence is a key limitation. ESD reliably provides complete resection and an accurate pathological diagnosis but is associated with risk such as perforation or bleeding. In addition, both EMR and ESD may be ineffective in treating subepithelial lesions that extend beyond the submucosa. Endoscopic full-thickness resection (EFTR) is an emerging innovative endoscopic therapy which was developed to overcome the limitations of EMR and ESD. Advantages include enabling a transmural resection, complete resection of complex colorectal lesions involving the mucosa to the muscularis propria. Recent studies comparing EFTR with current resection techniques and radical surgery for relatively complicated and larger lesion have provided promising results. If the current trajectory of research and development is maintained, EFTR will likely to become a strong contender as an alternative standard of care for advanced colonic lesions. In the current study we aimed to address this need, and highlighted the areas of future research, while stressing the need for multinational collaboration provide the steppingstone(s) needed to bring EFTR to the mainstream.

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Section: Endoscopic Full-thickness Resectionmentioning

confidence: 99%

“…OTSC is a clip-type full-thickness suturing device but is still unable to close defects larger than 2 cm. Several studies have reported the usefulness of the device for closure of fistulas, iatrogenic perforations and anastomotic leakage after surgery (13)(14)(15)(16)). The overstitch is not available worldwide and even in China.…”

Section: Introductionmentioning

confidence: 99%

Colon Sparing Endoscopic Full-Thickness Resection for Advanced Colorectal Lesions: Is It Time for Global Adoption?

Ding

Song

et al. 2022

Front. Oncol.

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“…Los clips Ovesco (over-the-scope), también conocidos como clips en garra de oso, son un dispositivo endoscópico de clipaje para el afrontamiento de tejidos por abordaje endoscópico (1) , cuyo uso en principio se dio para el cierre de fístulas y perforaciones del tracto gastrointestinal alto y posteriormente se extendió su utilización para casos de sangrado, resecciones de tumores submucosos y fijaciones de stents esofágicos (2) , gracias a su capacidad de agarre, fijación y fácil aplicación (1,2) . Dado que hay pocos reportes en la literatura de su uso en casos de exclusión pilórica con este dispositivo, compartimos este caso sobre un paciente con obstrucción duodenal por compresión extrínseca en relación con un conglomerado retroperitoneal, a quien se le realizó una gastroyeyunoanastomosis con finalidad derivativa, con un posterior proceso fistuloso yeyunal y colección intraabdominal que requirió drenaje percutáneo, ante lo cual se decidió realizar una exclusión pilórica con el dispositivo Ovesco, con el que presentó una adecuada evolución y cierre del proceso fistuloso.…”

Section: Introductionunclassified

Exclusión pilórica con dispositivo Ovesco (over-thescope) en caso de fístula yeyunal en obstrucción duodenal de etiología maligna

Morales¹,

Navia²,

Sánchez-Cortés

et al. 2022

Rev. colomb. Gastroenterol.

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Se reporta el caso de un hombre de 25 años con diagnóstico de tumor de células germinales no seminomatoso que ingresó a urgencias por cuadro clínico de dolor abdominal difuso asociado con distensión y múltiples episodios eméticos. Ante la sospecha clínica de obstrucción intestinal se realizó una tomografía abdominal contrastada que mostró una obstrucción en la tercera porción duodenal por compresión extrínseca ocasionada por múltiples conglomerados retroperitoneales. Se decidió el tiempo quirúrgico para una derivación gastrointestinal en la que se realizó una gastroyeyunoanastomosis por técnica convencional; hacia el quinto día posoperatorio presentó un deterioro clínico dado por episodios febriles, dolor abdominal y taquicardia. Se realizó una nueva tomografía abdominal que reportó una colección intraabdominal en el flanco izquierdo de 12 x 12 x 5 cm secundaria a proceso fistuloso yeyunal, se realizó un manejo de la colección con drenaje percutáneo por radiología intervencionista y alojamiento de catéteres de drenaje, y se realizó una esofagogastroduodenoscopia con el fin de ejecutar una técnica de exclusión pilórica con dispositivo Ovesco (over-the-scope) como manejo de la fístula yeyunal, con la que se obtuvo éxito técnico. Durante el posoperatorio se realizó como seguimiento una radiografía de vías digestivas que confirmó la no continuidad pilórica con adecuada permeabilidad de la gastroyeyunoanastomosis, y una tomografía abdominal contrastada que mostró una disminución de la colección intraabdominal sin extravasaciones del medio de contraste. El desenlace favorable de este caso sugiere la utilidad del dispositivo Ovesco en casos de fístulas del tracto gastrointestinal proximal, sobre todo en aquellos pacientes con múltiples comorbilidades o mal estado general que se favorecen de procedimientos mínimamente invasivos que disminuyan el riesgo de desenlace fatal.

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“…With advances in endoscopic techniques and equipment, large clips for the closure of vascular-enteric fistulas have come forward[ 12 ]. Per the literature and in our institution, such clips are successfully used for endoscopic closure of full-thickness gastrointestinal wall defects as well as interenteric or enterocutaneous fistulas[ 13 , 14 ]. Thus, clipping of fistulas has now become feasible, and the clipping of aorta-duodenal fistulas might be the next step forward.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic treatment of primary aorto-enteric fistulas: A case report and review of literature

Berner-Hansen

Olsen

Brandstrup

2021

WJGE

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BACKGROUND Primary aorto-enteric fistula (PAEF) is a rare condition, traditionally treated in the acute, bleeding phase with open surgery or endovascular repair. However, these approaches have high morbidity and mortality, indicating a need for new methods. With advances in endoscopic techniques and equipment, haemoclipping of fistulas has now become feasible. Therefore, we present a systematic review of the English literature and a rare case of a PAEF successfully treated by endoscopic haemoclipping. CASE SUMMARY A 74-year-old man with an abdominal aortic aneurysm presented with symptoms of haemorrhagic shock and bloody stools. An oesophago-gastro-duodenoscopy was performed with haemoclipping of a suspected PAEF in the third part of the duodenum. Afterward, a computed tomography-angiography showed a contrast filled protrusion from the abdominal aortic aneurysm. Based on the clinical presentation and the combined endoscopic and radiographic findings, we argue that this is a case of a PAEF. CONCLUSION Endoscopic therapy appears capable of achieving haemodynamic stabilisation in patients with bleeding PAEF, serving as a bridge to final therapy.

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Endoscopic closure of gastrointestinal perforations and fistulas using the Ovesco Over-The-Scope Clip system at a tertiary care hospital center

Cited by 8 publications

References 9 publications

Colon Sparing Endoscopic Full-Thickness Resection for Advanced Colorectal Lesions: Is It Time for Global Adoption?

Colon Sparing Endoscopic Full-Thickness Resection for Advanced Colorectal Lesions: Is It Time for Global Adoption?

Exclusión pilórica con dispositivo Ovesco (over-thescope) en caso de fístula yeyunal en obstrucción duodenal de etiología maligna

Endoscopic treatment of primary aorto-enteric fistulas: A case report and review of literature

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