Successful management of a duodenal perforation using a through-the-scope suturing device after failed attempt at closure with an over-the-scope clip

Novel devices for third‐space endoscopy procedures

“…38,39 TTS suturing has also been shown to be effective for mucosal incision closure after esophageal POEM and G-POEM. 35,40 Furthermore, preliminary data from our group suggests that TTS suturing may be associated with less procedure time and similar closure rates when compared with the Overstitch for mucosotomy closure during G-POEM. 41…”

“…The low profile of the TTS system permits easy maneuvering in otherwise unstable or difficult locations in the GI tract. 35 However, there are some practical considerations. First, tension on the suture is prone to breakage when excessive force is applied.…”

“…This increases procedural efficiency and potentially avoids losing position and sight of the target lesion during scope exchange. The low profile of the TTS system permits easy maneuvering in otherwise unstable or difficult locations in the GI tract 35 . However, there are some practical considerations.…”

Novel rendezvous technique for covered metal stent placement using balloon-assisted endoscope in duodenal perforation

“…Duodenal perforations pose a significant medical challenge. While endoscopic closure can be attempted [1,2], these cases often necessitate surgical intervention [3]. In situations where surgery carries high risks, placing a covered metal stent offers a viable alternative [4,5].…”