Endoscopic tacking system as a novel tissue approximation measure for very large EMR defects
Tara Keihanian1, Mohamed O Othman1, Salmaan A Jawaid1
1Department of Medicine, Division of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas.
Summary
The HeliX tacking system effectively closes large endoscopic resection defects. This novel through-the-scope device simplifies tissue approximation, reducing risks like bleeding and perforation after endoscopic procedures.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Medical Devices
Background:
- Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) require defect closure to prevent complications.
- Current closure methods have limitations, including scope withdrawal and difficulty with large defects.
- The through-the-scope HeliX tacking system offers a novel solution for tissue approximation.
Purpose of the Study:
- To demonstrate a technique for tissue approximation of large post-EMR/ESD defects using the HeliX tacking system.
- To evaluate the feasibility and effectiveness of the HeliX tacking system for large colonic and gastric defects.
Main Methods:
- A case series describing the use of the HeliX tacking system for large defects (10-cm colon, 5-cm stomach).
- Utilized a zig-zag running pattern for the colonic defect and a figure-8 pattern for the gastric defect.
- Employed a novel through-the-scope tissue apposition device.
Main Results:
- Successful and easy tissue approximation was achieved in both large defect cases.
- Four sets of tacks were used for the colonic defect and two for the gastric defect.
- No immediate or delayed adverse events were observed post-procedure.
Conclusions:
- The HeliX tacking system is a valuable tool for defect closure after EMR and ESD.
- It is particularly useful for large resection beds, especially in the right colon and confined spaces.
- Through-the-scope suturing offers an integrated solution for tissue apposition.
