THE OVER THE SCOPE GRASPER – A NEW TOOL FOR PANCREATIC NECROSECTOMY AND BEYOND – FIRST MULTICENTER EXPERIENCE

Aims Endoscopic treatment of pancreatic necrosis can be challenging and time consuming because sticky necrotic debris is sometimes difficult to remove. With the Over-The-Scope-Grasper, a new tool has recently become available for this purpose, which is also useful for other indications. The aim of this observational study was to evaluate the efficacy and safety of this new device in a multicenter setting.

Methods The Over-The-Scope-Grasper (OTSG Xcavator^TM – Ovesco Endoscopy AG, Tübingen, Germany) was used in 8 centers between November 2020 and October 2021 for appropriate indications. Procedural parameters were documented in a predefined questionnaire, with special respect to clinical success and safety.

Results A total of 50 procedures were performed. Most of the procedures were pancreatic necrosectomies (31 transgastric, 4 transduodenal). In 69% access to the necrosis cavity was established by a lumen apposing metal stent (LAMS). The technical and clinical success of necrosectomy was 97%, with a mean of 7 pieces of necrosis removed (mean procedure time 47 min). In addition, the device has been used to remove blood clots (n=5), to clear insufficiency cavities before endoluminal vacuum therapy (n=5), and to remove foreign bodies from the upper gastrointestinal tract (n=5). No clinically relevant complications were reported in any of the 50 procedures.

Conclusions First multicenter data demonstrate that the Over-The-Scope-Grasper is an effective and save device for endoscopic pancreatic necrosectomy. Due to its easy handling the device is also appropriate for removing foreign bodies and blood clots, or cleaning insufficiency cavities prior to endoluminal vacuum therapy.

Publication History

Article published online:
14 April 2022