A novel grasp-and-loop closure method for defect closure after endoscopic full-thickness resection (with video)

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Procedures

Background:

• Endoscopic full-thickness resection (EFTR) is a minimally invasive technique for gastrointestinal (GI) lesions originating from the muscularis propria.
• Effective closure of the resulting wall defect is crucial for successful EFTR outcomes.

Purpose of the Study:

• To evaluate the feasibility and efficacy of a novel, simplified endoscopic grasp-and-loop (GAL) closure method.
• The GAL method utilizes an endo-loop with grasping forceps for defect closure after EFTR.

Main Methods:

• The study included 13 patients with gastric submucosal tumors (SMTs) originating from the muscularis propria (MP) layer.
• EFTR was performed, followed by defect closure using the endoscopic GAL method with grasping forceps assistance.
• Patient data, tumor characteristics, procedural details, and postoperative outcomes were assessed.

Main Results:

• The endoscopic GAL closure was successfully performed in all 13 patients without laparoscopic assistance.
• The mean procedure time was 43.5 minutes, with the GAL closure taking a mean of 9.4 minutes.
• No major adverse events were reported, and no residual lesions or recurrence were observed during follow-up.

Conclusions:

• The endoscopic grasp-and-loop (GAL) closure method is a feasible, effective, and safe option for managing gastric defects post-EFTR.
• This simplified technique offers a promising solution for defect closure in endoscopic gastrointestinal surgery.