Endoscopic Hemoclipping Using a Transparent Cap in Technically Difficult Cases

Kim, Ji; Ss, Kim; Park, S; Han, Jun; Jk, Kim; Sw, Han; Choi, Kyung Hwa; Is, Chung; Kw, Chung; Sun, Haibo

doi:10.1055/s-2003-41512

Cited by 21 publications

(4 citation statements)

References 7 publications

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“…Furthermore, endoscopic hemostasis can be challenging in some scenarios, even for the most experienced endoscopists. The presence of hematic residues and clots in the gastrointestinal tract can pose technical difficulties that may prolong the procedure time or make it impossible [ 14 ]. One of the characteristics of PuraStat is that it is a transparent jelly-like substance prone to immiscibility with the blood.…”

Section: Discussionmentioning

confidence: 99%

Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series

et al. 2023

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Background and Objectives: A novel synthetic self-assembling peptide, PuraStat, has been introduced as a hemostatic agent. This case series aimed to evaluate the clinical efficacy of PuraStat for gastrointestinal bleeding during emergency endoscopy. Cases: Twenty-five patients with gastrointestinal bleeding who had undergone emergency endoscopy with PuraStat between August 2021 and December 2022 were retrospectively examined. Six patients were receiving antithrombotic agents, and ten patients with refractory gastrointestinal bleeding had undergone at least one endoscopic hemostatic procedure. The breakdown of bleeding was gastroduodenal ulcer/erosion in 12 cases, bleeding after gastroduodenal or colorectal endoscopic resection in 4 cases, rectal ulcer in 2 cases, postoperative anastomotic ulcer in 2 cases, and gastric cancer, diffuse antral vascular ectasia, small intestinal ulcer, colonic diverticular bleeding, and radiation proctitis in each case. The method of hemostasis was only PuraStat application in six cases, and hemostasis in combination with high-frequency hemostatic forceps, hemostatic clip, argon plasma coagulation, and hemostatic agents (i.e., thrombin) in the remaining cases. Rebleeding was observed in three cases. Hemostatic efficiency was observed in 23 cases (92%). Conclusions: PuraStat has the expected hemostatic effect on gastrointestinal bleeding during emergency endoscopy. The use of PuraStat should be considered in emergency endoscopic hemostasis of gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 99%

Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series

et al. 2023

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“…In that regard, attachable caps can help the endoscope reach a desired lesion more perpendicularly. In their study, Kim et al 37 showed that while there were no statistically significant differences between the hemostasis rates of patients treated with the cap and those without, placing a transparent cap at the end of the endoscope helped endoscopists clip a lesion too tangential to be clipped with greater ease due to having a superior view. Having a cap also decreased the risk of accidental mucosal damage during clip deployment, as endoscopists would simply cover the clip within the cap prior to its use.…”

Section: Providing An Optimal Approach Angle To a Targetmentioning

confidence: 99%

The role of cap-assisted endoscopy and its future implications

Kim,

Lee

2024

Clin Endosc

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Cap-assisted endoscopy refers to a procedure in which a short tube made of a polymer (mostly transparent) is attached to the distal tip of the endoscope to enhance its diagnostic and therapeutic capabilities. It is reported to be particularly useful in: (1) minimizing blind spots during screening colonoscopy, (2) providing a constant distance from a lesion for clear visualization during magnifying endoscopy, (3) accurately assessing the size of various gastrointestinal lesions, (4) preventing mucosal injury during foreign body removal, (5) securing adequate workspace in the submucosal space during endoscopic submucosal dissection or third space endoscopy, (6) providing an optimal approach angle to a target, and (7) suctioning mucosal and submucosal tissue with negative pressure for resection or approximation. Here, we review various applications of attachable caps in diagnostic and therapeutic endoscopy and their future implications.

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“… 27 A non-randomized prospective study compared the success rates of achieving bleeding control using hemoclips with and without the aid of a transparent cap. 28 In this study, hemoclipping with the cap allowed for the clipping of lesions that were situated too tangentially to be clipped without the use of the cap. Movements resulting from the patient's rapid respiration during emergency hemostasis often destabilize the positioning of the scope and hemostatic devices.…”

Section: Endoscopic Managementmentioning

confidence: 99%

Endoscopic Management of Nonvariceal Upper Gastrointestinal Bleeding: State of the Art

et al. 2015

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Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common reasons for hospitalization and a major cause of morbidity and mortality worldwide. Recently developed endoscopic devices and supporting apparatuses can achieve endoscopic hemostasis with greater safety and efficiency. With these advancements in technology and technique, gastroenterologists should have no concerns regarding the management of acute upper GI bleeding, provided that they are well prepared and trained. However, when endoscopic hemostasis fails, endoscopy should not be continued. Rather, endoscopists should refer patients to radiologists and surgeons without any delay for evaluation regarding the appropriateness of emergency interventional radiology or surgery.

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Endoscopic Hemoclipping Using a Transparent Cap in Technically Difficult Cases

Cited by 21 publications

References 7 publications

Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series

Emergency Endoscopic Hemostasis for Gastrointestinal Bleeding Using a Self-Assembling Peptide: A Case Series

The role of cap-assisted endoscopy and its future implications

Endoscopic Management of Nonvariceal Upper Gastrointestinal Bleeding: State of the Art

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