Endoscopic full-thickness resection for gastrointestinal lesions using the over-the-scope clip system: a case series

Abstract

The over-the-scope clip (OTSC) system was developed for the closure of gastrointestinal defects but can also be used for endoscopic resection. This report describes the efficacy and safety of endoscopic full-thickness resection (eFTR) using the OTSC system. In this retrospective, observational, open-label case study, a total of 17 patients underwent eFTR using a dual clip and cap technique. The indications were: carcinoids, incompletely resected colon cancers involving the mucosa or submucosa, recurrent fibrosed adenoma of the colon, and submucosal lesions. The technical success was 94 % (16 /17). The complete resection (R0) rate was 100 %. There were no complications. In summary, the described minimally invasive method to perform eFTR of complex gastrointestinal lesions appears to be effective and safe.

Endoscopic full-thickness resection of a submucosal right colon lesion

“…A novel endoscopic full-thickness resection device (Ovesco Endoscopy, Tübin-gen, Germany) has been developed based on the combination of an overthe-scope clip with an enlarged resection cap (21 mm) and a snare preloaded in the distal rim of the cap [1,2]. We report the case of a 53-year-old woman with a history of abdominal panniculitis with fat necrosis and perivasculitis with giant cell histiocytosis.…”

Clips for closure of full-thickness defects

“…There were no complications reported [64]. A mixed series of 17 patients included 2 stomach SETs (1 carcinoid and 1 "scattered spleen tissue"); a "close-first" approach was employed and no complications were reported [65].…”

“…There are human descriptions of EFTR in the colon for early cancer [69][70][71][72], difficult-to-resect adenomatous polyps [65,73,74], and neuroendocrine tumors [65,75]. A larger mixed series of patients that included 14 with colorectal lesions underwent successful EFTR in all but one; closure was with the OTSC [65].…”

Endoscopic Full-Thickness Resection of Colorectal Lesions with the New FTRD System: Single-Center Experience

“…In the first cases described, the lesions were targeted and aspirated into the transparent distal cap, and standard over-the-scope clips (OTSC) were deployed. The pseudopolyps located above the clip were then resected using an oval electrocautery snare [6-8]. The full-thickness resection device (FTRD; Ovesco Endoscopy, Tuebingen, Germany) is an over-the-scope system which allows a single-step EFTR after the placement of a modified OTSC [9].…”