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Endoscopy
DOI: 10.1055/a-2421-9767
Innovations and brief communications

A novel reopenable clip with sharp claw for complete closure of mucosal defects after colorectal endoscopic submucosal dissection

Naohisa Yoshida 
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Ryohei Hirose 
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
2   Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Osamu Dohi 
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Yoshikazu Inagaki 
3   Department of Gastroenterology, Nishizin Hospital, Kyoto, Japan
,
Takaaki Murakami
4   Department of Gastroenterology, Aiseikai Yamashina Hospital, Kyoto, Japan
,
Yutaka Inada
5   Department of Gastroenterology, Kyoto First Red Cross Hospital, Kyoto, Japan
,
Yasutaka Morimoto
6   Department of Gastroenterology, Kyoto Saiseikai Hospital, Kyoto, Japan
,
Reo Kobayashi
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Ken Inoue
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
,
Elsayed Ghoneem
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
7   Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
Yoshito Itoh
1   Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Correction: A novel reopenable clip with sharp claw for complete closure of mucosal defects after colorectal endoscopic submucosal dissectionEndoscopy eFirst
DOI: 10.1055/a-2467-3324

Abstract

Background The MANTIS Closure Device (MCD; Boston Scientific, Marlborough, Massachusetts, USA) is a reopenable clip with a sharp claw used for closure after endoscopic submucosal dissection (ESD). We evaluated the effectiveness of the MCD for fast and complete closure after colorectal ESD.

Methods Cases involving closure with the MCD after ESD of 20–60-mm colorectal lesions between April 2023 and January 2024 were reviewed. The primary end point was complete closure of the ESD defect with the MCD. Secondary end points included closure time, delayed bleeding, delayed perforation, and post-ESD coagulation syndrome (PECS). MCD application involved: 1) grasping the mucosa on the anal-side of the defect; 2) pushing the clip toward the oral-side mucosa and deploying it; 3) adding other reopenable clips for complete closure.

Results 61 cases involving MCD were analyzed. Mean tumor size was 32.3 (SD 9.2) mm. Complete closure rate was 98.4% and mean closure time was 6.9 (SD 2.6) minutes. The mean number of MCDs and other clips used was 1.0 (SD 0.1) and 4.7 (SD 1.4), respectively. Rates of delayed bleeding, delayed perforation, and PECS were 0%, 0%, and 9.8%, respectively.

Conclusion Fast and complete closure after colorectal ESD was successfully achieved using the MCD.

Supplementary Material



Publication History

Received: 21 May 2024

Accepted after revision: 25 September 2024

Accepted Manuscript online:
25 September 2024

Article published online:
06 November 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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