Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Advantages of a Point-of-care Digital Rectoscope for Colorectal Surgical Practice: A Video-supported Case Series.","authors":"David J Nijssen, Roel Hompes, Wytze Laméris","doi":"10.1097/SLE.0000000000001372","DOIUrl":"10.1097/SLE.0000000000001372","url":null,"abstract":"<p><strong>Purpose: </strong>Point-of-care (POC) diagnostic tools can support timely and efficient clinical decision-making. The introduction of a POC digital rectoscope has the potential to enhance colorectal surgical practice by enabling immediate bedside endoscopic evaluation in different settings.</p><p><strong>Methods: </strong>This case series describes 5 cases, with video documentation illustrating the potential benefits of using a portable digital rectoscope in outpatient follow-up, inpatient postoperative care, and emergency settings.</p><p><strong>Results: </strong>In a tertiary referral center, POC rectoscopy effectively supported the detection of anastomotic leakage and rectal perforation, response evaluation after neoadjuvant treatment for rectal cancer, and facilitated follow-up after treatment for anastomotic leakage.</p><p><strong>Conclusions: </strong>POC digital rectoscopy shows promise in enhancing the diagnostic efficiency of colorectal care. Further studies are warranted to evaluate its clinical impact and cost-effectiveness for the illustrated indications.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Various Diet Regimens Involving Sennoside for Bowel Cleansing Prior to Colonoscopy: A Randomized Controlled Trial.","authors":"Hilmi Bozkurt, Enver Reyhan, Cumhur Özcan, Tahsin Çolak, Mustafa Onur Beştaş, Didem Derici Yıldırım","doi":"10.1097/SLE.0000000000001368","DOIUrl":"10.1097/SLE.0000000000001368","url":null,"abstract":"<p><strong>Background: </strong>Consuming only low-fiber food on the day before the procedure is recommended as standard practice for bowel cleansing in patients using polyethylene glycol (PEG). However, there have been few studies to date investigating the optimal dietary regimen for patients using the more cost-effective Sennoside A+B calcium before colonoscopy. The present study compares the quality of bowel preparation of patients following a clear diet and those following a low-fiber diet on the day before colonoscopy among patients using Sennoside A+B calcium.</p><p><strong>Methods: </strong>This prospective, randomized, and investigator-blinded study was conducted between November 2023 and February 2024. Included in the study were 150 patients aged 18 years and over with a mean age of 55.6±14 years, with 75 patients assigned to the clear diet group and 75 patients to the low-fiber diet group. The assessment of colonoscopy cleanliness before colonoscopy was conducted using the Boston Bowel Preparation Scale (BBPS).</p><p><strong>Results: </strong>None of the patients experienced intolerance. The mean overall total cleanliness score, measured using the BBPS, was 7.24±2.1, with 7.48 ± 2.1 in the low-fiber diet group and 7.0 ±2.1 in the clear liquid diet group. No significant difference in cleanliness was found between the 2 groups ( P =0.096).</p><p><strong>Conclusion: </strong>Patients using cost-effective Senna for bowel cleansing before colonoscopy can safely consume low-fiber foods on the day before the procedure. In the present study, a clear diet offered no benefit over a more comfortable and better-tolerated diet in terms of colon cleanliness.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National, Multicenter, Survey-based Analysis of Clinical Practice and Utilization of Bougie in Metabolic and Bariatric Surgery.","authors":"Jinshan Zhang, Youna Lin, Zhiyong Dong, Cunchuan Wang, Weixin Huang, Zhong Cheng, Zefeng Xia, Yingxu Li, Zhuoqi Wei, Wah Yang","doi":"10.1097/SLE.0000000000001385","DOIUrl":"10.1097/SLE.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>Bougie is critical for achieving the optimal sleeve size or pouch creation in metabolic and bariatric surgery (MBS). This study investigates the clinical application and challenges of specialized bougie in MBS within China, aims to identify targeted solutions, and seeks to guide clinical practice.</p><p><strong>Methods: </strong>A survey questionnaire, developed in collaboration with MBS experts through a webinar, was distributed online to MBS centers across China from March 9 to 15, 2023. Statistical analysis was used to evaluate the survey responses.</p><p><strong>Results: </strong>The survey collected 183 valid responses from 28 provinces, including autonomous regions and municipalities. Of these, 86.34% of centers reported using specialized bougie for MBS, with 79.23% using it frequently. Among those frequently using bougie, 40.51% reused bougie postdisinfection due to the high costs of new bougies. The most common bougie sizes used were 36Fr for laparoscopic sleeve gastrectomy and laparoscopic gastric bypass, with other sizes ranging from 30Fr to 38Fr. However, 41.53% of centers reported complications related to bougie use, with tension rupture and esophageal injury being the most frequent.</p><p><strong>Conclusions: </strong>This nationwide survey offers insights into the clinical application and challenges of specialized bougie in Chinese MBS centers. There is a need for enhanced education, standardization, and training to mitigate complications and improve patient outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of \"Polyp\" and \"Pseudo Polyp\" in Gallbladder Polyps, Single-center Experience.","authors":"Deniz Tazeoglu, Ahmet Cem Esmer","doi":"10.1097/SLE.0000000000001363","DOIUrl":"10.1097/SLE.0000000000001363","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of gallbladder polyps is 0.3% to 9.5%. Gallbladder polyps are divided into polyps and pseudo polyps. We aim to determine the rate of polyps after histopathologic examination in patients who were operated on for gallbladder polyps and to choose the factors affecting the diagnosis of polyps.</p><p><strong>Patients and methods: </strong>Patients who underwent cholecystectomy between January 2012 and January 2022 were analyzed retrospectively. Demographic data of the patients, anthropometric measurements, preoperative radiologic imaging methods, characteristics (size and number of polyps), and histopathologic results of the gallbladder after cholecystectomy were recorded. After histopathologic examination, the patients were grouped as gallbladder polyp and pseudo polyp and compared.</p><p><strong>Result: </strong>A total of 162 (4.7%) patients were included in the study. 109 (67.3%) of the patients were in the polyp group, and 53 (32.7%) were in the pseudo polyp group. Polyp size and number were larger in the polyp group than in the pseudo polyp group and were odd in number ( P = 0.03, P < 0.001). The radiologic polyp size cut-off value to identify the polyp was >8 mm (sensitivity: 84.2%, specificity: 66.0%).</p><p><strong>Conclusion: </strong>Gallbladder polyps are a common pathology. The distinction between true and pseudo polyp is critical. Therefore, it is essential to distinguish between polyps and pseudo polyps for cholecystectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Colon Surgery for Colon Cancer: Long-Term Oncologic Results from a 10-Year Follow-Up Study.","authors":"Niyaz Shadmanov, Vusal Aliyev, Baris Bakir, Suha Goksel, Oktar Asoglu","doi":"10.1097/SLE.0000000000001378","DOIUrl":"10.1097/SLE.0000000000001378","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the outcomes of minimally invasive surgery (MIS) for colon cancer and analyze the impact of tumor localization on survival.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 842 consecutive patients who underwent curative MIS (laparoscopic and robotic) for stage I to III colon adenocarcinoma between 2001 and 2024. The surgical technique adhered to oncological principles, ensuring adequate resection margins and proper lymph node dissection. Patient characteristics, operative data, perioperative outcomes, histopathologic findings, and oncological outcomes were analyzed.</p><p><strong>Results: </strong>The study included 842 patients (59.4% male, 40.6% female) with a median age of 60.3 years. Tumor localization was right colon in 29.5%, transverse colon in 6.5%, and left colon in 64% of cases. In our study, 814 cases (96.7%) were performed using laparoscopic surgery, while 28 cases (3.3%) were performed using robotic surgery. The mean operative time was 135 minutes, with a mean hospital stay of 6 days. Conversion to open surgery occurred in 3% of cases. The mean number of lymph nodes removed was 35 (range: 8 to 72). Pathologic examination revealed that 65% of cases were node-positive stage III. During a mean follow-up of 10 years, local recurrence (LR) was observed in 2.8% of patients, with no significant difference based on tumor localization. Distant metastases (DM) occurred in 12.7% of patients. The 10-year disease-free survival (DFS) rate for all patients was 75%, and the overall survival (OS) rate was 78.7%. The 10-year DFS rates for right colon, transverse colon, and left colon cancers were 74%, 71%, and 76%, respectively. Similarly, the OS rates for the same groups were 78.9%, 75%, and 79%, respectively. Statistical analysis revealed no significant differences in DFS ( P =0.851) or OS ( P =0.789) among the 3 tumor localization groups.</p><p><strong>Conclusion: </strong>Our study demonstrated that MIS is a promising approach for achieving favorable long-term oncological outcomes in colon cancer patients. Consequently, MIS is established as the standard approach in colon cancer surgery. Although right colon tumors are often associated with poorer disease-free and overall survival rates, this study found no significant differences in DFS or OS among left, transverse, and right colon tumors.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reintervention After Endoscopic Ultrasound-Guided Choledochoduodenostomy for Distal Malignant Biliary Obstruction.","authors":"Suprabhat Giri, Bhavik Shah, Jimmy Narayan, Radhika Chavan, Viswanath R Donapati, Shivam Khare, Jijo Varghese, Bipadabhanjan Mallick, Aditya Kale, Sridhar Sundaram","doi":"10.1097/SLE.0000000000001382","DOIUrl":"10.1097/SLE.0000000000001382","url":null,"abstract":"<p><strong>Introduction: </strong>Studies analyzing the factors associated with reintervention after endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) are limited. We aimed to analyze the incidence and predictors of reintervention in patients with malignant biliary obstruction undergoing EUS-CDS.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients with malignant distal biliary obstruction undergoing EUS-CDS from 8 tertiary care centers in India. The study's primary outcome was reintervention due to stent migration or blockage. The secondary outcomes included clinical success and adverse events. Multivariate analysis using the logistic regression model was used to identify the independent predictors of reintervention.</p><p><strong>Results: </strong>A total of 134 patients were included in the study. The technical and clinical success rates were 97.8% (131/134) and 93.9% (123/131), respectively. Periprocedural adverse events (AE) were seen in 6% (8/134) cases. Over a median follow-up of 20 weeks, reintervention was required in 8.4% of the cases after a median interval of 11 weeks. On multivariate analysis, cholangitis at presentation (odds ratio [OR] 6.26) and the absence of coaxial stent with concomitant duodenal stent (OR: 7.41) were independent predictors of reintervention in the overall cohort. On subgroup analysis of patients undergoing EUS-CDS with self-expanding metallic stent (SEMS), the absence of a coaxial stent with concomitant duodenal stent (OR: 10.15) was an independent predictor of reintervention.</p><p><strong>Conclusion: </strong>Reintervention on follow-up after EUS-CDS is required in around 8.4% of cases. The absence of coaxial stent with concomitant duodenal stent was an independent predictor of reintervention in the overall cohort as well as in those undergoing EUS-CDS with SEMS.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-controlled Analgesia Using Ropivacaine (0.25%) Through Transversus Abdominis Plane vs. Epidural Route for Postoperative Pain Relief Following Midline Laparotomy: A Single Center Open-label Randomized Control Trial (Wireless Trial).","authors":"Pankaj Kumar, Kallol Kumar Das Poddar, Upendra Hansda, Swagata Tripathy, Bhaskar Rao, Tushar Subhadarshan Mishra, Dillip Muduly, Prakash Kumar Sasmal","doi":"10.1097/SLE.0000000000001384","DOIUrl":"10.1097/SLE.0000000000001384","url":null,"abstract":"<p><strong>Introduction: </strong>The WIRELESS trial compared the postoperative analgesic effect of the bilateral transversus abdominis plane patient-controlled analgesia (TAP-PCA) with that of epidural patient-controlled analgesia (E-PCA) using ropivacaine 0.25%.</p><p><strong>Methodology: </strong>A hundred patients aged between 18 and 85 years and planned for upper midline laparotomy (Class I and II wounds) under general anesthesia were randomized into TAP-PCA (50) and E-PCA (50) groups. The PCA pump used for the study was designed to deliver a baseline infusion rate of 5 mL/hour (0.25%). The patients were instructed to press the PCA button, as and when required to deliver an additional dose of 2 mL, with 15-minutes lockout period. Both groups received 1 g of paracetamol infusion every 8 hours. The pain score was evaluated at 3, 6, 12, and 24 hours and then every 12 hours till 72 hours postoperatively. The requirements of rescue analgesia (injection tramadol), out-of-bed mobilization, and recovery of bowel function were recorded. Drug-related side effects and catheter-related complications were also noted.</p><p><strong>Results: </strong>Five (10%) patients in the TAP arm and 17 (34%) patients in the epidural arm could not complete the study due to complications/failure. The intention-to-treat analysis indicates that VAS scores were similar in both groups (47 in the epidural PCA group and 48 in the TAP-PCA group) at 3, 12, 24, 36, 48, 60, and 72 hours. Rescue analgesia (tramadol) was similar in both groups (0.21, 0.58 vs. 0.13, 0.44). There were no significant differences observed between the 2 groups in terms of out-of-bed mobilization and pulmonary complications. Nonetheless, the TAP arm showed the earlier passage of the first flatus and a shorter hospital stay compared with the epidural arm.</p><p><strong>Conclusion: </strong>PCA through the TAP route is not inferior to the epidural route for managing postoperative pain. Because of fewer contraindications and complications, TAP-PCA can be considered an alternative to epidural PCA.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlap Versus π-Shaped Esophagojejunostomy After Laparoscopic Total Gastrectomy for Gastric Cancer: A Comparative Study.","authors":"Luyang Zhang, Junjun Ma, Jingzhu Li, Sen Zhang, Hiju Hong, Xuan Zhao, Bo Feng, Zirui He, Xiao Yang, Lu Zang, Minhua Zheng, Abe Fingerhut","doi":"10.1097/SLE.0000000000001388","DOIUrl":"10.1097/SLE.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of medical professionals are choosing to use totally laparoscopic total gastrectomy (TLTG) as a treatment option for gastric cancer. However, the optimal reconstruction method is still under debate. The objective of this study is to evaluate the immediate results of 2 intracorporeal esophagojejunostomy techniques: overlap (isoperistaltic side-to-side) (O) and pi-shaped (π) (anisoperistaltic side-to-side) anastomosis.</p><p><strong>Methods: </strong>Hospital records of 110 patients who underwent esophagojejunostomy (group O, n=65 or group π, n=45) after TLTG from January 2016 to December 2019 were retrospectively reviewed. The demographic and clinicopathologic characteristics, along with the surgical and pathologic results, were recorded, compared, and evaluated for immediate impacts.</p><p><strong>Results: </strong>The demographic characteristics of the 2 groups exhibited no significant disparities. Moreover, there were no statistically notable differences in tumor size, lymph node count, or TNM stage between the 2 groups. All surgeries were successfully completed without any complications or need for conversion to laparotomy, and there were no occurrences of postoperative mortality. In addition, there were no statistically significant variances between the 2 groups in terms of total operation time, estimated blood loss, time to first flatus, or length of postoperative hospital stay. Time for esophagojejunostomy, however, was statistically significantly shorter in group π than in group O (27.4±5.2 vs. 36.7±5.0 min) ( P <0.001). No statistically significant difference was found between the 2 groups with regard to postoperative complications: 5 grade I, 6 grade II, and 1 grade IIIa in group O (n=12) versus 5 grade I, 3 grade II, 2 grade IIIa, and 1 grade IIIb in group π (n=11). At 6-month endoscopy and oral water-soluble contrast medium follow-up, no anastomotic complication was noted.</p><p><strong>Conclusions: </strong>The π anastomosis is feasible, safe, with the need for fewer cartridges and is eventually a time-saving procedure for esophagojejunostomy with no hand-sewing involved. In this study, both methods have shown favorable short-term results in the treatment of gastric cancer.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Single Stapling Natural Orifice Specimen Extraction Surgery (ssNOSES) in Rectal Cancer.","authors":"Yanle Fang, Hongxun Ruan, Xiaoning Qin, Lin Lin","doi":"10.1097/SLE.0000000000001398","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001398","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the outcomes of single stapling natural orifice specimen extraction surgery (ssNOSES) with double stapling natural orifice specimen extraction surgery (dsNOSES) in anterior resection for rectal cancer.</p><p><strong>Methods: </strong>A total of 100 patients with rectal cancer were selected from the Colorectal Department of the Second Hospital of Hebei Medical University. These patients underwent Natural Orifice Specimen Extraction Surgery (NOSES) between July 2018 and July 2020. Fifty patients who underwent ssNOSES were compared with fifty patients who underwent dsNOSES. The comparison focused on patient demographics, surgical outcomes, and complications, with a particular emphasis on operative time, cost, and complications.</p><p><strong>Results: </strong>Four cases of anastomotic leakage were observed in the dsNOSES group, and this group also incurred higher costs. Although the surgical time for ssNOSES was longer, the procedure was associated with lower costs and no cases of anastomotic leakage.</p><p><strong>Conclusions: </strong>ssNOSES is a cost-effective and safer alternative to dsNOSES. Furthermore, the surgical time for ssNOSES can be reduced through training and experience.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Endoscopic Clip For Effective Management of Gastrointestinal Perforations: A Feasibility Study in a Porcine Model.","authors":"Jeongho Sohn, Sunseok Yoon, Kwang Dae Hong","doi":"10.1097/SLE.0000000000001397","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001397","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal (GI) perforations typically occur as complications following endoscopic procedures or intestinal anastomosis surgery. Endoscopic closure of these perforations is desirable as it avoids the risks associated with surgery. Although several endoscopic devices have been developed to address this issue, none have yet demonstrated consistently effective clinical outcomes. This study introduces a novel endoscopic clip assembly designed to overcome these challenges.</p><p><strong>Materials and methods: </strong>The Z-shaped clip, named the kinetic utility (KU) clip, was constructed with nitinol, allowing it to operate at 45 °C. When the clip is delivered endoscopically, it can close perforations with a predeformed configuration that is triggered by temperature. Ex vivo experiments were conducted using porcine stomach tissue to compare the performance of the KU clip with through-the-scope clips (TTSCs). Maximal force and area under the curve (AUC) on the force-displacement curve were measured to assess the retention capability of the clip in tissue. The in vivo experiment involved creating iatrogenic perforations in a pig, applying the KU clip, and monitoring its healing and safety outcomes.</p><p><strong>Results: </strong>Ex vivo experiments showed a difference between the TTSC and KU groups with a P-value of 0.08 for maximal force and 0.01 for AUC. The in vivo experiment validates the effectiveness of the KU clip, as there was complete healing of the perforation site with no significant adverse reactions during the experimental period.</p><p><strong>Conclusions: </strong>The KU clip demonstrates potential as a versatile and effective tool for endoscopic management of GI perforations.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}