Commentary

Several techniques are available for defect closure, including over-the-scope (OTS) [11] [22] and through-the-scope (TTS) [33] [44] devices. However there are still constraints due to the location, size, and/or shape of the defect, endoscopist experience, and the need for scope reinsertion with the device in place [55].

Therefore, I commend the modified endoscopic hand-suturing technique for defect closure introduced by Dou Lizhou et al. This technique, based on TTS introduction of a modified suturing needle with absorbable barbed suture represents a significant step forward, enabling right-colon defect closure after resection without requiring endoscope reinsertion. This advancement could pave the way for new, optimized closure devices for complex anatomical locations.

Endoscopic suturing is a crucial step in expanding the indications for therapeutic endoscopy beyond third-space procedures. To achieve this, it must be rapid, safe, and versatile, reinforcing the essential role of TTS suturing in clinical practice.

Publication History

Article published online:
25 March 2025

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