[Endoscopic sutures offer more surgical options]

Endoscopic sutures can be used in various clinical situations where closure or fixation is needed. Stents that migrate and dislocated probes can be fixated by endoscopic sutures. The sutures can be used to stop gastrointestinal bleeding. It is possible to close perforations, leaks and fistulas with endoscopic sutures, but as with ordinary sutures, the indication must be correct for the procedure to be successful. Endoscopic sleeve gastroplasty (ESG) can be done by a series of sutures reducing the volume of the stomach. Defects after endoscopic resections, where bleeding or perforations can be expected, can be closed with endoscopic sutures. Complications are uncommon but intraabdominal fluid collection may occur after ESG. Endoscopic sutures have the same possibilities and limitations as traditional or laparoscopic sutures. Properly used, the method is safe, but the instruments are still difficult to work with and require an experienced endoscopist who has undergone proper training.