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Related Experiment Video

Updated: Oct 6, 2025

Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
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Published on: March 28, 2025

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Endoscopic through-the-scope suturing.

Linda Y Zhang1, Michael Bejjani1, Bachir Ghandour1

  • 1Johns Hopkins Medical Institutions, Baltimore, Maryland.

Videogie : an Official Video Journal of the American Society for Gastrointestinal Endoscopy
|January 21, 2022
PubMed
Summary
This summary is machine-generated.

The novel X-Tack system (TTSS) effectively closes large gastrointestinal defects through the endoscope without removal. This through-the-scope suturing offers a safe and valuable new option for endoscopic mucosal closure.

Keywords:
EDGE, EUS-directed transgastric ERCPESD, endoscopic submucosal dissectionG-POEM, gastric peroral endoscopic myotomyLAMS, lumen-apposing metal stentOTSC, over-the-scope clipOTSS, over-the-scope suturingPOEM, peroral endoscopic myotomyTTSC, through-the-scope clipTTSS, through the scope suturing

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Area of Science:

  • Gastroenterology and Endoscopy
  • Minimally Invasive Surgery
  • Medical Device Technology

Background:

  • Increasing endoscopic resections for early GI neoplasia create larger mucosal defects.
  • Current closure methods like clips and sutures often require endoscope removal, limiting use in certain areas.
  • A need exists for through-the-scope devices to close larger defects effectively.

Purpose of the Study:

  • To evaluate the feasibility and safety of the novel X-Tack system for through-the-scope suturing (TTSS).
  • To demonstrate indications for endoscopic mucosal adhesion using TTSS in various gastrointestinal defect closures.

Main Methods:

  • A video case series illustrating five distinct applications of TTSS.
  • Cases included closure of duodenal and cecal EMR defects, mucostomy after peroral endoscopic myotomy, and gastrogastric fistula closure.

Main Results:

  • Successful closure of all five defects using one to two TTSS systems.
  • No adverse events such as bleeding or perforation were observed during a median follow-up of 30 days.

Conclusions:

  • Through-the-scope suturing (TTSS) is a valuable endoscopic mucosal closure device.
  • TTSS allows closure without endoscope removal, suitable for large, distant, or challenging defects.
  • Further research on learning curve, comparative trials, and cost-effectiveness is warranted.