BACKGROUND: Over-the-scope clips (OTSCs) are increasingly used for the closure of perforations/fistulae, hemostasis and endoscopic full-thickness resection (FTRD system). When OTSC-associated complications occur or re-therapy at the OTSC site is needed, OTSC removal may be indicated. An experimental study in an animal model and a case series have shown good results for OTSC removal with a bipolar cutting device. We present a larger clinical study using this device. METHODS: Data of all consecutive patients with indication for OTSC removal were collected and analyzed retrospectively. OTSCs were cut at two opposing sites using a bipolar grasping device to apply short direct current impulses. OTSC fragments were extracted with a standard forceps and a cap at the tip of the endoscope to avoid tissue damage. RESULTS: Between December 2012 and February 2016 a total of 42 OTSC removals in the upper (n = 25) and lower (n = 17) gastrointestinal tract have been performed at our department. Overall technical success, defined as cutting the OTSC at two opposing sites and extraction of both fragments, was achieved in 92.9% (39/42) of all cases. Successful fragmentation of the OTSC was achieved in 97.6% (41/42). Minor bleedings were rare and could be managed endoscopically in all cases. There were no perforations and no major or delayed bleedings. CONCLUSION: Endoscopic OTSC removal with a bipolar cutting device is feasible, effective and safe. This technique can be applied in the upper and lower gastrointestinal tract.
BACKGROUND: Over-the-scope clips (OTSCs) are increasingly used for the closure of perforations/fistulae, hemostasis and endoscopic full-thickness resection (FTRD system). When OTSC-associated complications occur or re-therapy at the OTSC site is needed, OTSC removal may be indicated. An experimental study in an animal model and a case series have shown good results for OTSC removal with a bipolar cutting device. We present a larger clinical study using this device. METHODS: Data of all consecutive patients with indication for OTSC removal were collected and analyzed retrospectively. OTSCs were cut at two opposing sites using a bipolar grasping device to apply short direct current impulses. OTSC fragments were extracted with a standard forceps and a cap at the tip of the endoscope to avoid tissue damage. RESULTS: Between December 2012 and February 2016 a total of 42 OTSC removals in the upper (n = 25) and lower (n = 17) gastrointestinal tract have been performed at our department. Overall technical success, defined as cutting the OTSC at two opposing sites and extraction of both fragments, was achieved in 92.9% (39/42) of all cases. Successful fragmentation of the OTSC was achieved in 97.6% (41/42). Minor bleedings were rare and could be managed endoscopically in all cases. There were no perforations and no major or delayed bleedings. CONCLUSION: Endoscopic OTSC removal with a bipolar cutting device is feasible, effective and safe. This technique can be applied in the upper and lower gastrointestinal tract.
Authors: Marc O Schurr; Franziska E Baur; Martina Krautwald; Marion Fehlker; Manfred Wehrmann; Thomas Gottwald; Ruediger L Prosst Journal: Surg Endosc Date: 2014-10-16 Impact factor: 4.584
Authors: Helmut Neumann; Hiwot Diebel; Klaus Mönkemüller; Andreas Nägel; Dane Wildner; Michael Vieth; Jürgen Siebler; Markus F Neurath Journal: Gastrointest Endosc Date: 2012-11 Impact factor: 9.427
Authors: Klaus Mönkemüller; Shajan Peter; Jay Toshniwal; Daniel Popa; Marzena Zabielski; Richard D Stahl; Jayapal Ramesh; C Mel Wilcox Journal: Dig Endosc Date: 2013-07-16 Impact factor: 7.559
Authors: Arthur Schmidt; Bettina Riecken; Michael Damm; Oscar Cahyadi; Markus Bauder; Karel Caca Journal: Endoscopy Date: 2014-04-25 Impact factor: 10.093
Authors: Arthur Schmidt; Peter Bauerfeind; Christoph Gubler; Michael Damm; Markus Bauder; Karel Caca Journal: Endoscopy Date: 2015-03-12 Impact factor: 10.093