Loop9 closure technique for mucosal defects after colorectal endoscopic submucosal dissection (with video)

Area of Science:

• Gastroenterology
• Surgical Innovation
• Endoscopic Procedures

Background:

• Mucosal defect closure post-colorectal endoscopic submucosal dissection (ESD) is crucial for preventing delayed adverse events (AEs).
• Existing methods for defect closure require evaluation for efficacy and safety.

Purpose of the Study:

• To assess the feasibility and effectiveness of the Loop9 method for closing mucosal defects after colorectal ESD.
• To evaluate the Loop9 method's impact on reducing delayed AEs.

Main Methods:

• Retrospective single-center study using prospectively collected data (May 2020-March 2023).
• Loop9 device deployed via a single instrument channel, anchored with clips, and tightened for closure.
• Primary outcome: complete closure rate; secondary outcomes: sustained closure, defect size, closure time, AE incidence.

Main Results:

• Complete closure achieved in 96.6% of 118 cases; sustained closure in 93.9%.
• Median defect size: 30 mm; median closure time: 14 minutes; median additional clips: six.
• One case of stenosis requiring balloon dilatation; no post-ESD bleeding or delayed perforation.

Conclusions:

• The Loop9 method is a feasible and effective technique for colorectal ESD mucosal defect closure.
• High rates of complete and sustained closure were observed, with a favorable safety profile.