Multipurpose use of the ‘bear claw’ (over‐the‐scope‐clip system) to treat endoluminal gastrointestinal disorders

Digestive Endoscopy - Tập 26 Số 3 - Trang 350-357 - 2014
Klaus Mönkemüller1,2, Shajan Peter2, Jay Toshniwal1, Daniel Popa2, Marzena Zabielski1, Richard Stahl3, Jayapal Ramesh2, C. Mel Wilcox2
1Department of Internal Medicine, Gastroenterology and Infectious Diseases, Marienhospital, Bottrop, Germany
2Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence
3Division of Surgery, University of Alabama, Birmingham, Alabama, USA

Tóm tắt

Background and AimThe ‘bear‐claw’ or over‐the‐scope‐clip system (OTSC; Ovesco Endoscopy, Tübingen, Germany) is a new clipping device developed for closure of large luminal gastrointestinal (GI) defects. The aim of the present study was to evaluate the clinical outcomes of patients treated with the OTSC.MethodsThe present study was an observational, open‐label, retrospective, single‐arm case series conducted at two hospitals with tertiary care endoscopy. It involved 20 clip applications in 16 patients (median age 65.8 years [range 51–90 years], seven women) with GI defects from fistulas and anastomotic dehiscence and peptic ulcer bleeding.ResultsThe range of indications included gastrointestinal bleeding (n = 6), gastrocutaneous fistulas (n = 3), esophagotracheal and/or esophagopleural fistulae (n = 3), resection ofsubmucosal tumor (n = 2), stent fixation (n = 1), and anastomotic leak after esophagectomy (n = 1). The overall success rate for the OTSC device was 75% (12 out of 16 patients). The overall per case success rate was 70% (14 of 20 applications). Mean follow up was 10 months (range 1–10). There were no complications (0%) related to endoscopy, sedation or application of the clipping device.ConclusionsThe OTSC system is a useful device in a variety of clinical scenarios including the management of larger GI leaks and fistulas, GI bleeding, full‐thickness resection of tumors, and stent anchoring, even in very old and frail patients.

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Digestive Endoscopy

Tập 26 Số 3

350-357

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