Endoscopy 2010; 42(12): 1108-1111
DOI: 10.1055/s-0030-1255924
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

“Sparing the surgeon”: clinical experience with over-the-scope clips for gastrointestinal perforation

L.  Seebach1 , P.  Bauerfeind1 , C.  Gubler1
  • 1Department of Gastroenterology and Hepatology, University Hospital of Zürich, Switzerland
Further Information

Publication History

submitted 26 February 2010

accepted after revision 21 July 2010

Publication Date:
30 November 2010 (online)

With increasingly advanced therapeutic endoscopic procedures and more complex gastrointestinal surgery, endoscopists are more often confronted with perforations, fistulas, and anastomotic leakages for which nonsurgical closure is desired. The over-the-scope clip (OTSC) is a novel endoscopic tool for consideration in such situations. We treated seven patients (age range 35 – 83 years; five men, two women), three with colonic perforation, one with perforation of the stomach, and three with anastomotic leakage after gastrointestinal surgery. Follow-up was at least 74 days. Eight OTSCs were deployed. In all but one patient closure of the perforation was demonstrated. Further surgery was avoided in four of the seven patients. The OTSC is a system that is easy to handle and safe. It seems to be ideally suited to use for a relatively small (iatrogenic) perforation, where a single clip can be released with carbon dioxide insufflation. Anastomosis leakage and larger dehiscence can also be treated to avoid further surgery, but the utility in this situation needs to be defined in the future.


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P. BauerfeindMD 

Gastroenterology, Endoscopy Unit
University Hospital Zürich

Rämistrasse 100
8091 Zürich

Fax: +41-44-2554474

Email: peter.bauerfeind@usz.ch