The Use of Over-the-scope Clips to Close Perforations and Fistulas

Gastrointestinal (GI) wall defects such as perforations and fistulas present complex clinical challenges. With the evolution of therapeutic endoscopy, over-the-scope clips (OTSCs) have emerged as a minimally invasive solution offering effective closure of transmural GI defects. This review evaluates the use of OTSCs across a spectrum of GI pathologies, including iatrogenic and noniatrogenic perforations of the esophagus, stomach, duodenum, and colon, as well as various types of fistulas. As endoscopic technology advances, further studies are needed to optimize their application, standardize protocols, and enhance long-term efficacy in managing complex GI defects.