Over the Scope Clip

Singhal, Shashideep; Changela, Kinesh; Papafragkakis, Haris; Anand, Sury; Krishnaiah, Mahesh; Duddempudi, Sushil

doi:10.1097/mcg.0b013e318296ecb9

Cited by 56 publications

(17 citation statements)

References 11 publications

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“…Its uses have been expanded to include prophylactic closure of large mucosal defects after ESD, resection of submucosal tumors and esophageal stent fixation 20. At present, data are limited regarding its role in management of iatrogenic perforations occurring during endoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

et al. 2017

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Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.

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Section: Discussionmentioning

confidence: 99%

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

et al. 2017

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“…However, due to the narrow wingspan of the TTSC, multiple clips were needed for the repair, the leak rate after the repair of large perforations exceeding 1 cm was significant, and the treatment ended in mere surface layer closure rather than in full-thickness closure (6,7,10). The OTSC system, on the other hand, has higher gripping and holding strengths (10,11) and it is designed to achieve full-thickness closure of perforations with diameters up to 3 cm (6). It has been reported to be particularly effective for closing defects and leaks without causing fibrosis at the edges (8,10).…”

Section: Discussionmentioning

confidence: 99%

“…The OTSC system, on the other hand, has higher gripping and holding strengths (10,11) and it is designed to achieve full-thickness closure of perforations with diameters up to 3 cm (6). It has been reported to be particularly effective for closing defects and leaks without causing fibrosis at the edges (8,10). According to a systematic review of the clinical outcomes of endoscopic closure of acute iatrogenic gastrointestinal perforations, the success rate using the OTSC system was remarkably high, namely at 87.8% (7).…”

Section: Discussionmentioning

confidence: 99%

“…The OTSC clip is deployed by rotating the hand wheel to pull the thread connected to the OTSC clip. The OTSC Twin Grasper with two jaws, which can be separately opened as an assistive device to approximate tissue, is also available (10) (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…The OTSC system has made the closure of gastrointestinal tract defects, such as perforations, anastomotic insufficiency, and fistula , as well as hemostasis in difficult-to-treat non-variceal bleeding, possible (6-10). It also helps to achieve a more reliable closure, as its wide mouth allows it to hold a greater amount of tissue than the conventional through-the-scope clip (TTSC) (8,10). We herein describe a patient in whom the OTSC system was useful for the treatment of a duodenal perforation caused by endoscopic submucosal dissection (ESD).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2016

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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.

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Endoscopic Treatment of Perforations and Fistulas

Kumta

DeFilippis

Sharaiha

et al. 2014

Advanced Colonoscopy

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Over the Scope Clip

Abstract: OTSC is easy to use with good results, thus decreasing the morbidity and mortality associated with the complications secondary to both diagnostic and therapeutic endoscopy and avoiding surgery in many situations.

Cited by 56 publications

References 11 publications

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

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

Endoscopic Treatment of Perforations and Fistulas

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