CC BY 4.0 · Endoscopy 2025; 57(S 01): E294-E295
DOI: 10.1055/a-2563-1474
E-Videos

Novel endoscopic full-thickness resection device for colon polyp resection

1   Department of Medicine, University of Minnesota Medical Center, Minneapolis, United States (Ringgold ID: RIN14400)
,
Rahul Karna
2   Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical Center, Minneapolis, United States (Ringgold ID: RIN14400)
,
Roberto Osorio-Cintron
3   Gastroenterology Section, Minneapolis Veteran Affairs Medical Center, Minneapolis, United States
,
Natalie Wilson
1   Department of Medicine, University of Minnesota Medical Center, Minneapolis, United States (Ringgold ID: RIN14400)
,
Daniela Guerrero Vinsard
3   Gastroenterology Section, Minneapolis Veteran Affairs Medical Center, Minneapolis, United States
,
Brian J Hanson
3   Gastroenterology Section, Minneapolis Veteran Affairs Medical Center, Minneapolis, United States
,
4   Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, United States (Ringgold ID: RIN129263)
› Institutsangaben
 

    Endoscopic full-thickness resection (EFTR) allows for the management of scarred and fibrotic lesions that are not amenable to endoscopic mucosal resection or endoscopic submucosal dissection (ESD). Two main methods of performing EFTR include exposed and nonexposed EFTR. In exposed EFTR, the lesion is resected followed by defect closure. In nonexposed EFTR, the defect is closed prior to resection of the lesion.

    The Padlock FTR System (Steris, Mentor, Ohio, USA) is a novel full-thickness resection (FTR) device that includes a Padlock design clip to achieve nonexposed EFTR and then uses a pre-loaded snare to resect the lesion ([Fig. 1]). To the best of our knowledge, we show the first reported case of in-human use of this device ([Video 1]).

    Zoom Image
    Fig. 1 Dedicated, novel full-thickness resection device that includes a clip and pre-loaded snare for lesion resection.

    Qualität:
    Resection of a large sigmoid polyp using a novel full-thickness resection device.Video 1

    A 60-year-old man with a history of >20 polyps and prior ESD for three 4- to 6-cm rectosigmoid polyps presented for endoscopic resection of a rectosigmoid polyp adjacent to a prior ESD resection site. A 20-mm sessile polyp was found in the sigmoid colon next to a previously placed cinch at the site of a prior polyp resection. Given extensive scarring at the site, the decision was made to pursue EFTR. The polyp was successfully resected using this novel FTR device ([Fig. 2]). No adverse events occurred. Examination of the resection site showed the fatty patch, consistent with full-thickness resection, and the clip in place ([Fig. 3]). Pathology revealed a well-differentiated, invasive adenocarcinoma with a depth of submucosal invasion of 600 microns ([Fig. 4]). Deep and lateral margins were negative (R0 resection) for dysplasia.

    Zoom Image
    Fig. 2 Successful resection of the 20-mm sigmoid polyp using the novel full-thickness resection device.
    Zoom Image
    Fig. 3 Post-resection examination showed the fatty patch, consistent with full-thickness resection. The clip was in the appropriate position.
    Zoom Image
    Fig. 4 Invasive adenocarcinoma with submucosal invasion to a depth of 600 microns. Deep and lateral margins were negative (R0 resection).

    This device could be a useful tool in the armamentarium for EFTR of previously manipulated colon polyps and lesions with superficial submucosal invasion. Further reports are needed to confirm its safety and efficacy.

    Endoscopy_UCTN_Code_TTT_1AQ_2AD_3AF

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    Conflict of Interest

    M. B. is a consultant for Boston Scientific, Steris Endoscopy, and a paid speaker for Cook Medical. No other authors have conflicts of interest to disclose.

    Correspondence

    Mohammad Bilal, MD
    Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus
    12635 E. Montview Blvd.
    Aurora, CO 80045
    United States   

    Publikationsverlauf

    Artikel online veröffentlicht:
    09. April 2025

    © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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

    Zoom Image
    Fig. 1 Dedicated, novel full-thickness resection device that includes a clip and pre-loaded snare for lesion resection.
    Zoom Image
    Fig. 2 Successful resection of the 20-mm sigmoid polyp using the novel full-thickness resection device.
    Zoom Image
    Fig. 3 Post-resection examination showed the fatty patch, consistent with full-thickness resection. The clip was in the appropriate position.
    Zoom Image
    Fig. 4 Invasive adenocarcinoma with submucosal invasion to a depth of 600 microns. Deep and lateral margins were negative (R0 resection).