Closure methods and devices

The last decade of the 20th century and the first 2 decades of the 21st century dramatically changes in the flexible endoscopy world. New endoscopic procedures were introduced into clinical practice, stimulating development of new endoscopic devices and techniques and significantly expanding the armamentarium of surgeons and gastroenterologists specializing in therapeutic flexible endoscopy. Through-the-scope endoscopic clips have become an important tissue-approximating instrument, often in combination with PolyLoops. Over-the-scope endoscopic clips demonstrate effectiveness in the closure of gastrointestinal (GI) tract fistulas and small iatrogenic perforations. The Overstitch endoscopic suturing system is a versatile tissue-approximating device, which produces effective, reliable, surgical-quality closure of GI tract defects. This device, and other developing endoscopic suturing systems may, eventually become the universal tool for endoscopic correction of fistulas, closure of submucosal tunnels, iatrogenic perforations, mucosal and full-thickness defects postendoscopic resection of GI tract lesions.