X-tackling the path to closure: post-endoscopic submucosal dissection defect resolution strategies

Neves, João A. Cunha; Chaves, Jéssica; Ribeiro, Mário Dinis; Libânio, Diogo

http://hdl.handle.net/10400.1/26342

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Abstract(s)

Mucosal defect closure after endoscopic submucosal dissection (ESD) may reduce the likelihood of delayed bleeding and perforation [1]. Several devices are currently available for the closure of mucosal defects, including through-the-scope (TTS) and over-the-scope (OTS) clips, and OTS endoscopic suturing devices. However, defect closure can be technically demanding, with TTS clips typically limited to defects up to 20 mm, whereas OTS clips and suturing equipment require endoscope removal for device placement. More recently, the X-Tack Endoscopic HeliX Tacking System™, a novel TTS suturing device, has emerged as a potential tool for overcoming technical issues related to previous closure devices. We present 2 cases of gastric post-ESD defect closure with X-Tack, highlighting the technical challenges and main steps required to achieve high-quality closure without exposed submucosal tissue.