Endoscopic slipknot clip suturing method: an ex vivo feasibility study (with video)

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Innovation

Background:

• Endoscopic submucosal dissection (ESD) can result in large mucosal defects.
• Closing these defects often requires specialized equipment or techniques.
• A simplified suturing method for single-channel endoscopes is needed.

Purpose of the Study:

• To develop and evaluate a novel slipknot clip suturing method.
• To assess the efficacy of this technique for closing mucosal defects using a single-channel endoscope.

Main Methods:

• A slipknot clip suturing technique was developed for single-channel endoscopes.
• Twelve 30-mm mucosal defects were created in an ex vivo bovine model.
• The method involves anchoring a slipknot loop with clips and tightening it to close the defect.

Main Results:

• Complete closure of all 12 mucosal defects was achieved.
• A significant reduction in procedure time was observed between the first and second halves of the study (865 ± 213 vs 556 ± 103 seconds, P = .009).

Conclusions:

• The slipknot clip suturing method provides an effective means for complete closure of large mucosal defects.
• This technique simplifies defect closure using a single-channel endoscope.