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Endoscopic Submucosal Dissection Including the Minor Papilla for a Duodenal Laterally Spreading Tumor.

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Related Experiment Video

Updated: Mar 7, 2026

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Endoscopic closure after intraluminal surgery.

Teppei Akimoto1, Osamu Goto1, Toshihiro Nishizawa1

  • 1Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|February 10, 2017
PubMed
Summary

Endoscopic submucosal dissection (ESD) offers curative resection for GI neoplasms but risks bleeding and perforation. Various endoscopic closure techniques aim to minimize these adverse events, enhancing therapeutic endoscopy safety and efficacy.

Keywords:
adverse eventendoscopic closureendoscopic full-thickness resectionendoscopic submucosal dissectionendoscopic suturing

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Therapeutic Endoscopy

Background:

  • Endoscopic submucosal dissection (ESD) is a curative endoscopic treatment for gastrointestinal epithelial neoplasms, enabling en bloc resection.
  • Postoperative complications such as bleeding and delayed perforation remain significant challenges following ESD.
  • Existing endoscopic closure methods include endoscopic clips, hemoclips with supplementary devices, and specialized suturing devices.

Purpose of the Study:

  • To review and discuss various endoscopic closure techniques for iatrogenic gastrointestinal defects post-ESD.
  • To highlight the development of endoscopic full-thickness suturing techniques inspired by NOTES and EFTR.
  • To emphasize the potential of secure defect closure in expanding the scope of therapeutic endoscopy.

Main Methods:

  • Review of established and emerging endoscopic closure techniques for gastrointestinal defects.
  • Discussion of methods including over-the-scope clips, threaded bars, stitches, staplers, and curved needle suturing.
  • Exploration of the principles behind endoscopic full-thickness suturing.

Main Results:

  • Several endoscopic closure techniques are available to manage iatrogenic defects after ESD.
  • These techniques aim to prevent or minimize postoperative bleeding and perforation.
  • The development of secure closure methods is crucial for advancing therapeutic endoscopy.

Conclusions:

  • Endoscopic closure techniques are vital for improving the safety profile of ESD.
  • Further evidence accumulation and technique standardization are needed for widespread adoption.
  • Secure closure of iatrogenic defects holds promise for expanding the applications of therapeutic endoscopy.