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Endoscopy 2016; 48(08): 766-770
DOI: 10.1055/s-0042-105559
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel occluder for endoscopic closure of gastrotomy: an ex vivo and in vivo animal study

Ji Hee Kim
1   Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,Incheon, Korea
,
Bo-In Lee
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Sung Hak Lee
3   Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Joon Sung Kim
1   Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,Incheon, Korea
,
Myong Ki Baeg
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Jae Myung Park
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
In-Seok Lee
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Byung-Wook Kim
1   Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,Incheon, Korea
,
Sang Woo Kim
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Hwang Choi
1   Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,Incheon, Korea
,
Myung-Gyu Choi
2   Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted 26 October 2015

accepted after revision 10 March 2016

Publication Date:
21 April 2016 (online)

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Background and aims: We evaluated the feasibility of a novel occluder for endoscopic closure of natural orifice transluminal endoscopic surgery (NOTES) gastrotomy.

Methods: The occluder is a self-expandable, membrane-covered, metal structure for endoscopic delivery through gastrointestinal (GI) wall defects. The procedure time and air-tightness of endoscopic closure for a 12-mm perforation were compared for a through-the-scope clip group and an occluder group in an ex vivo animal study. The feasibility and safety of the occluder for the closure of NOTES gastrotomy were also evaluated in an in vivo animal study.

Results: In the ex vivo study, the median procedure time for closure was significantly shorter and the minimum air-leakage pressure was significantly greater in the occluder group than in the endoclip group. In the in vivo study, immediate air-tight sealing was achieved by application of the occluder and there were no serious adverse events. All animals showed spontaneous detachment of the occluder into the gastric lumen and complete healing within 4 – 8 weeks.

Conclusions: The novel occluder can provide immediate and permanent sealing for NOTES gastrotomy.