title: [Experimental study on a new method for colonoscopic closure of large-bowel perforations with the OTSC clip].
abstract: Iatrogenic perforation of the colon during interventional endoscopic procedures, e.g., mucosectomy, is a problematic complication, as safe treatment often requires surgical repair. Iatrogenic perforation of the colon is indeed a rare complication; however, given the increasing case numbers in interventional endoscopy it is of considerable practical relevance. The closure of perforations can be achieved with conventional endoscopic clips; however, these working channel based clips are often too small to close a perforation securely. Therefore, we have developed a novel endoscopic clipping system that can be attached to the tip of the endoscope. This over-the-scope-clip system (OTSC), made of Nitinol, was tested in an experimental trial (domestic pig, 50-60 kg) for its applicability for perforation closure. In acute experiments, tight endoscopic closure of 10 perforations in five animals was demonstrated; perforations were made through repeat biopsy. In three further animals, the postoperative course was studied over a period of 2 weeks. Peritonitis was not found in any of these animals. The local healing result at the site of implantation was good. Clips were present 2 weeks after the procedure. In this experimental study, the OTSC clip system was found to be a simple and secure method of iatrogenic colon perforation closure.
authors.affiliation: Steinbeis Hochschule Berlin, IHCI-Institut, Tübingen, Deutschland. marc.schurr@novineon.com
authors.forename: Marc O
authors.initials: MO
authors.lastname: Schurr
authors.forename: Christoph
authors.initials: C
authors.lastname: Hartmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
authors.forename: Chi-Nghia
authors.initials: CN
authors.lastname: Ho
authors.forename: Christine
authors.initials: C
authors.lastname: Fleisch
authors.forename: Gerhard
authors.initials: G
authors.lastname: Buess
mesh_terms: D000818:Animals; D020685:Colonoscopes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D007416:Intestinal Perforation / Q000601:surgery*; D007420:Intestine, Large / Q000293:injuries* / Q000601:surgery*; D013525:Surgical Instruments; D013552:Swine