Colorectal endoscopic full-thickness resection using a novel, flat-base over-the-scope clip: a prospective study

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Evaluating the Padlock Clip, a novel flat-based over-the-scope clip.
• Assessing its feasibility and safety for colorectal endoscopic full-thickness resection (eFTR).

Purpose of the Study:

• To determine the feasibility and safety of the Padlock Clip for colorectal eFTR.
• To evaluate its efficacy in resecting various colorectal lesions.

Main Methods:

• Prospective study including 26 patients with colorectal lesions <20mm.
• Indications included scar re-resection, recurrent adenomas, non-lifting polyps, and adenomas in diverticula.
• Utilized the Padlock Clip for endoscopic full-thickness resection (eFTR).

Main Results:

• Achieved 100% technical success and 92% full-thickness resection rates.
• Median procedure time was 43 minutes.
• 12% complication rate within 48 hours, including one perforation requiring surgery.
• Smaller specimen volumes were observed for eFTR of scars from larger original polyps (≥20mm).

Conclusions:

• The Padlock Clip demonstrated feasibility for colorectal eFTR in this initial series.
• The technique is relatively safe compared to surgery but may require technical improvements.
• Further research is needed to identify the most suitable indications for this eFTR method.