Volume 34, Issue 12 pp. 2152-2157
Endoscopy

Endoscopic closure of large colonic perforations with a novel endoscopic clip device: An animal study (with videos)

Zhi-jie Wang

Zhi-jie Wang

Department of Gastroenterology, Gongli Hospital, Second Military Medical University, Shanghai, China

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhi-jie Wang, Shi-yu Li, and Yan-hui Zhang contributed equally to the manuscript.Search for more papers by this author
Shi-yu Li

Shi-yu Li

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhi-jie Wang, Shi-yu Li, and Yan-hui Zhang contributed equally to the manuscript.Search for more papers by this author
Yan-hui Zhang

Yan-hui Zhang

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhi-jie Wang, Shi-yu Li, and Yan-hui Zhang contributed equally to the manuscript.Search for more papers by this author
Yan Chen

Yan Chen

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

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Ping-ping Zhang

Ping-ping Zhang

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

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Zhao-shen Li

Corresponding Author

Zhao-shen Li

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhao-shen Li, Yu Bai, and Dong Wang shared co-corresponding authorship.

Correspondence

Zhao-shen Li, Yu Bai, or Dong Wang, Digestive Endoscopy Center, Department of Gastroenterology, Gongli Hospital and Changhai Hospital, Second Military Medical University, No. 168, Changhai Road, Yangpu District, Shanghai 200433, China.

Email: [email protected]; [email protected]; [email protected]

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Yu Bai

Corresponding Author

Yu Bai

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhao-shen Li, Yu Bai, and Dong Wang shared co-corresponding authorship.

Correspondence

Zhao-shen Li, Yu Bai, or Dong Wang, Digestive Endoscopy Center, Department of Gastroenterology, Gongli Hospital and Changhai Hospital, Second Military Medical University, No. 168, Changhai Road, Yangpu District, Shanghai 200433, China.

Email: [email protected]; [email protected]; [email protected]

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Dong Wang

Corresponding Author

Dong Wang

Department of Gastroenterology, Gongli Hospital, Second Military Medical University, Shanghai, China

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

Zhao-shen Li, Yu Bai, and Dong Wang shared co-corresponding authorship.

Correspondence

Zhao-shen Li, Yu Bai, or Dong Wang, Digestive Endoscopy Center, Department of Gastroenterology, Gongli Hospital and Changhai Hospital, Second Military Medical University, No. 168, Changhai Road, Yangpu District, Shanghai 200433, China.

Email: [email protected]; [email protected]; [email protected]

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First published: 18 July 2019
Citations: 9
Declaration of conflict of interest: All authors disclosed no financial relationships relevant to this publication.
Author contribution: Zhao-shen Li and Dong Wang designed the device and the study. Yan Chen, Ping-ping Zhang, and Yu Bai made critical revision of the manuscript for intellectual content. Zhi-jie Wang performed the procedure of endoscopic closure and drafted the manuscript. Shi-yu Li and Yan-hui Zhang acted as assistants during the procedure, recorded the data, and made statistical analysis.
Financial support: Dr. Yu Bai is supported by the National Key R&D Program of China (2017YFC1308800 and 2018YFC1313103), and National Natural Science Foundation of China (grant nos 81670473 and 81873546), and Three Engineering Training Funds in Shenzhen (no. SYLY201718). Dr. Dong Wang is supported by the Shanghai Committee of Science and Technology (grant no. 18441900200) and Medical Discipline Construction Project of Pudong New Area Commission of Health and Family Planning (grant no. PWYGF2018-01).

Abstract

Background and Aim

An endoscopic clip device was newly designed to accomplish the closure of large gastrointestinal defects. The aim of this study was to determine the feasibility and efficacy of this device in an ex vivo experimental setting.

Methods

This prospective study was conducted in porcine colons (n = 5). A large (3–4 cm) linear full-thickness incision was created using a scalpel externally. The device was used for endoscopic closure. The procedure time, number of clips, and success rate of closure were determined.

Results

Ten defects were created in five porcine colons (two incisions in each specimen). Successful closure was achieved in all defects. The mean procedure time was 24.30 ± 4.42 min, the mean leak pressure is 28.30 ± 9.49 mmHg, and the mean number of additional conventional hemostatic clips used was 5.10 ± 0.99.

Conclusions

The results indicated that this clip achieved the convenient and reliable closure of large defects in the colon wall in an ex vivo porcine model and seems to be a promising option for closing large gastrointestinal perforations.

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