VideoGIE
Common indications for transoral flexible endoscopic suturing
Figure 1. Endoscopic full-thickness suturing system.
Flexible endoscopic full-thickness suturing is being performed for a variety of clinical indications. The OverStitch (Apollo Endosurgery, Austin, Tex, USA) is currently the only such device approved by the U.S. Food and Drug Administration (Fig. 1). This device is being increasingly used to anchor stents within the GI lumen, perform primary and revisional bariatric procedures, and approximate tissue defects. This platform allows one to perform both interrupted and running suture patterns using either absorbable or nonabsorbable sutures. This video presents a series comprising 3 frequently encountered indications for flexible endoscopic suturing (Video 1, available at www.giejournal.org). The first case demonstrates the deployment of a suture to secure an esophageal fully covered self-expandable metallic stent that had previously migrated despite the placement of endoscopic clips. The second case illustrates a technique
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
1000 GASTROINTESTINAL ENDOSCOPY Volume 81, No. 4 : 2015
used for transoral gastric outlet reduction with simple interrupted sutures in a patient with weight regain after Roux-en-Y gastric bypass. The final case shows the closure of a posterior esophageal mucosal incision created during peroral endoscopic myotomy with a combination of simple interrupted and running sutures. Flexible endoscopic suturing is essential to the advancement of therapeutic endoscopy. This video demonstrates the efficient and safe use of an endoscopic suturing device that appears ready for “prime time.” DISCLOSURE Mouen A. Khashab is a consultant for Boston Scientific and Olympus America and has received research support from Cook Medical. All other authors disclose no financial relationships relevant to this publication. Vivek Kumbhari, MD, Alan H. Tieu, MD, Mouen A. Khashab, MD, Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
http://dx.doi.org/10.1016/j.gie.2014.10.038
www.giejournal.org
Common indications for transoral flexible endoscopic suturing
Figure 1. Endoscopic full-thickness suturing system.
Flexible endoscopic full-thickness suturing is being performed for a variety of clinical indications. The OverStitch (Apollo Endosurgery, Austin, Tex, USA) is currently the only such device approved by the U.S. Food and Drug Administration (Fig. 1). This device is being increasingly used to anchor stents within the GI lumen, perform primary and revisional bariatric procedures, and approximate tissue defects. This platform allows one to perform both interrupted and running suture patterns using either absorbable or nonabsorbable sutures. This video presents a series comprising 3 frequently encountered indications for flexible endoscopic suturing (Video 1, available at www.giejournal.org). The first case demonstrates the deployment of a suture to secure an esophageal fully covered self-expandable metallic stent that had previously migrated despite the placement of endoscopic clips. The second case illustrates a technique
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
1000 GASTROINTESTINAL ENDOSCOPY Volume 81, No. 4 : 2015
used for transoral gastric outlet reduction with simple interrupted sutures in a patient with weight regain after Roux-en-Y gastric bypass. The final case shows the closure of a posterior esophageal mucosal incision created during peroral endoscopic myotomy with a combination of simple interrupted and running sutures. Flexible endoscopic suturing is essential to the advancement of therapeutic endoscopy. This video demonstrates the efficient and safe use of an endoscopic suturing device that appears ready for “prime time.” DISCLOSURE Mouen A. Khashab is a consultant for Boston Scientific and Olympus America and has received research support from Cook Medical. All other authors disclose no financial relationships relevant to this publication. Vivek Kumbhari, MD, Alan H. Tieu, MD, Mouen A. Khashab, MD, Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
http://dx.doi.org/10.1016/j.gie.2014.10.038
www.giejournal.org
