Transmural gallbladder drainage using a novel endosonographic-guided suture (with video)

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Innovation

Background:

• Interventional endoscopic ultrasound (EUS) offers alternatives to surgery for gallbladder conditions.
• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is technically challenging and carries risks.
• A novel suturing device aims to improve EUS-GBD safety and ease.

Purpose of the Study:

• To assess the feasibility and safety of a new EUS-guided suturing device for gallbladder drainage.
• To evaluate if the device reduces technical difficulty and adverse events in EUS-GBD.
• To determine the device's potential impact on interventional EUS procedures.

Main Methods:

• A preclinical study involved 6 pigs randomized for EUS-GBD with or without the suturing device.
• The study recorded ease of use, stent deployment success, and adverse events.
• Animals were observed for 30 days post-procedure, followed by necropsy and histology.

Main Results:

• The suturing device significantly reduced the distance between the gastrointestinal lumen and gallbladder.
• Successful lumen-apposing metal stent (LAMS) deployment was achieved in all cases using the device.
• No adverse events were observed during the 30-day survival period or post-necropsy.

Conclusions:

• The novel suturing device is safe and effective for endoscopic anchoring of the gallbladder.
• This device facilitates successful EUS-GBD, potentially improving interventional EUS procedures.
• The findings suggest broader applications for this technology in EUS-guided interventions.