Novel Endoscopic Closure of Iatrogenic Hypopharyngeal Perforations Using Through-the-Scope Tissue Approximation Clips

Hypopharyngeal perforation is a rare but potentially life-threatening complication of upper aerodigestive tract instrumentation. Management strategies remain controversial, and data supporting flexible endoscopic closure in this region are limited. We describe 3 cases of iatrogenic hypopharyngeal perforations successfully managed with MANTIS through-the-scope tissue approximation clips as part of a multidisciplinary approach. All defects were closed endoscopically. Two patients achieved complete mucosal healing without surgical intervention. One patient experienced clinical decline related to comorbid illness rather than closure failure. Endoscopic closure using through-the-scope clips may be a feasible option in carefully selected patients when performed early with multidisciplinary collaboration.