Endoscopic hand-suturing for endoscopic submucosal dissection wound closure:a didactic clinical case presentation

Abstract Text The prophylactic post-ESD wound closure may represent a strategy to reduce the risk of delayed adverse events (AEs) such as bleeding and perforation. Until now, the closure of large GI defects has been technically challenging with standard endoscopic devices (e.g., endoclips). However, the introduction of Endoscopic Hand-Suturing techniques has enabled the effective closure of large GI wounds. Here, we report the clinical case of a 68-year-old man with a 40 mm LST-NG in the distal rectum who underwent ESD. The rich vascular pattern, intraprocedural bleedings and patient's need for early reintroduction of anticoagulation therapy (atrial fibrillation as a comorbidity) necessitated wound closure. We successfully performed a complete wound closure using an endoscopic needle-holder (SutuArt; Olympus Medical Systems) and a V-Loc 180 suture, size 3-0 (Medtronic) [1] [2].

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/29c34770-ea69-4ef1-9456-41401fc2210a/Uploads/16849_rossellamaresca_1_def.mp4

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Goto O, Oyama T, Ono H, Takahashi A, Fujishiro M, Saito Y, Abe S, Kaise M, Iwakiri K, Yahagi N.. Endoscopic hand-suturing is feasible, safe, and may reduce bleeding risk after gastric endoscopic submucosal dissection: a multicenter pilot study (with video). Gastrointest Endosc 2020; 91 (5): 1195-1202
• 2 Fang Z, Xu Y, Huang X.. Impact of prophylactic wound closure in colorectal ESD on postoperative wound complications: A meta-analysis. Int Wound J. 2024; 21 (3): e14783