Endoscopy 2013; 45(08): 655-660
DOI: 10.1055/s-0033-1344214
Original article
© Georg Thieme Verlag KG Stuttgart · New York

A simple novel endoscopic successive suture device: a validation study for closure strength and reproducibility

Y. Song*
1  Department of Mechanical Engineering, Korea University, Seoul, Korea
,
H. S. Choi*
2  Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
,
K. Kim
1  Department of Mechanical Engineering, Korea University, Seoul, Korea
,
Y. Kim
1  Department of Mechanical Engineering, Korea University, Seoul, Korea
,
B. G. Kim
1  Department of Mechanical Engineering, Korea University, Seoul, Korea
,
D. Hong
1  Department of Mechanical Engineering, Korea University, Seoul, Korea
,
B. Keum
2  Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
,
H. J. Chun
2  Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted 06 November 2012

accepted after revision 28 April 2013

Publication Date:
23 July 2013 (online)

Background and study aims: Endoscopic surgical technology has been developing rapidly. Although several successful endoscopic closure devices have already been introduced, only a few of them have demonstrated improvements in closure strength and reproducibility over conventional endoscopic clip closures or hand sutures. The objective of this study was to test the feasibility of a novel successive suturing device (SSD) by measuring closure strength and reproducibility.

Material and methods: Porcine stomach models were used in this study. Endoclips, full-thickness hand sutures, and the novel SSD sutures were used to close a perforation in the stomach wall, with 10 stomachs being tested for each closure method. Endoclips and SSD sutures were performed using a two-channel endoscope, and the hand sutures were performed from outside of the stomach wall. Air leakage pressure was measured to determine the closure strength and reproducibility of each method.

Results: The mean air leakage pressure of the SSD closure was 62.7 ± 8.2 mmHg. SSD-treated stomachs exhibited significantly greater air leakage pressure than Endoclip-treated stomachs. The standard deviation of bursting pressure in SSD stomachs was found to be significantly smaller than that of hand-sewn stomachs but was not different from that of Endoclip stomachs.

Conclusions: The consistent closure strength of SSD stomachs demonstrated the reliability and reproducibility of this new closure method. These promising results in closure strength and reproducibility suggest the feasibility of the proposed device for clinical applications.

* These authors contributed equally to this work