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Tissue apposition system: new technology to minimize surgery for endoscopically unresectable colonic polyps
C P Delaney1, B J Champagne, J M Marks
1Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA. conor.delaney@UHhospitals.org
Surgical Endoscopy
|May 22, 2010
Summary
The Tissue Apposition System (TAS) offers a safe way to close large defects after endoscopic polypectomy for unresectable polyps, potentially avoiding laparoscopic colectomy (LC) and enabling faster recovery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Endoscopic Technology
Background:
- Endoscopic resection of large or unresectable polyps can lead to significant defects.
- Laparoscopic colectomy (LC) is often required for these polyps, involving longer recovery times.
- Novel endoscopic closure devices aim to reduce the need for LC.
Purpose of the Study:
- To evaluate the feasibility and safety of the Tissue Apposition System (TAS) for closing defects after endoscopic polypectomy.
- To assess TAS as an alternative to LC for endoscopically unresectable polyps.
- To determine if TAS can facilitate faster recovery and shorter hospital stays.
Main Methods:
- A feasibility study involving patients with endoscopically unresectable polyps requiring LC.
- Polyp resection using endoscopic mucosal resection (EMR) or submucosal dissection with laparoscopic assistance.
- Closure of the polypectomy site using the TAS device under laparoscopic observation.
- Follow-up colonoscopy at 3 months to assess healing and recurrence.
Main Results:
- Seven patients (mean age 66) with large polyps (mean 30 mm) were treated.
- Five TAS procedures were successfully completed, with a mean hospital stay of 1.2 days and no complications.
- Two cases required conversion to LC (one unresectable polyp, one device failure).
- Follow-up showed complete healing without recurrence; one patient developed a mild, asymptomatic stricture.
Conclusions:
- The Tissue Apposition System (TAS) is safe for closing defects after endoscopic polypectomy of selected unresectable polyps under laparoscopic control.
- TAS technology shows potential to avoid laparoscopic colectomy (LC).
- This approach may lead to rapid recovery and shorter hospital stays for patients.
