Endoscopy 2018; 50(04): S165
DOI: 10.1055/s-0038-1637536
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

ESOPHAGEAL, HEPATOCOLIC AND COLOVESICAL FISTULAE MANAGED WITH THE NOVEL PADLOCK DEVICE FOR ENDOSCOPIC CLOSURE

B Velayos
1   Hospital Clínico de Valladolid, Gastroenterology, Valladolid, Spain
,
L Del Olmo
1   Hospital Clínico de Valladolid, Gastroenterology, Valladolid, Spain
,
J Trueba
2   Hospital Clínico de Valladolid, Radiology, Valladolid, Spain
,
J Herreros
3   Hospital Clínico de Valladolid, Surgery, Valladolid, Spain
,
L Merino
3   Hospital Clínico de Valladolid, Surgery, Valladolid, Spain
,
C Alonso
1   Hospital Clínico de Valladolid, Gastroenterology, Valladolid, Spain
,
JM González
1   Hospital Clínico de Valladolid, Gastroenterology, Valladolid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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    Aims:

    The Padlock system includes a nitinol clip that was recently introduced for endoscopic therapy. We report three different types of fistulae that were endoscopically managed with this novel over-the-scope nitinol clip device.

    Methods:

    Case 1: A 70-year-old male suffered from post-surgical gastroesophageal anastomotic leak. Gastroscopy revealed a 10 mm orifice at that level.

    Case 2: A 92-year-old woman presented with fever and abdominal pain. An abdominal CT scan revealed a 6-cm focal lesion consistent with a liver abscess. A percutaneous drain was placed and communication was found with the colon hepatic flexure.

    Case 3: A 69-year-old woman presented with enteruria two months after medical treated diverticulitis. An abdominal CT scan revealed a 18 mm fistulous tract between the sigmoid colon and the urinary bladder. Colonoscopy could located the fistulous opening after a cystoscopy inserted a guirewire to the colon.

    In the there cases a Padlock Clip was released and the defects were succesfully closed.

    Results:

    The Padlock system is a novel mechanical endoscopic closure system with characteristics that might well be considered particularly appealing. It differs with others devices in that setup does not involve the working channel, thus allowing improved lavage-aspiration. It also marketed without forceps, with only suction being used to introduce tissue into the cap before release. It consists of an 11-mm hexagonal nitinol ring with six inner needles that lies within a plastic cap that is fitted to the tip of the endoscope. The delivery system runs externally along the shaft of the endoscope.

    Conclusions:

    Although further studies are needed to confirm the efficacy and safety of the novel Padlock system for endoscopic closure, different types of fistulae could be effectively treated with it. Easy over-the-scope assembly and release is a factor to be reckoned with when considering its use.


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