title: Endoscopic full-thickness resection in the colon by using a clip-and-cut technique: an animal study.
abstract: BACKGROUND
  Although endoscopic resection techniques have been established for definitive therapy of mucosal neoplasia, complete histopathological assessment or resection of subepithelial lesions is not reliably possible.
  
  
  OBJECTIVE
  To overcome these limitations, a novel endoscopic full-thickness resection (EFTR) and closure technique was developed.
  
  
  METHODS
  Animal survival study.
  
  
  METHODS
  Eight female domestic pigs.
  
  
  METHODS
  Two-centimeter artificial distal colonic lesions were created endoscopically. EFTR of the lesions was attempted using a prototype device, which consists of a large transparent plastic cap with a preloaded snare and a modified over-the-scope clip. After the procedure, half of the animals were killed after 7 days, and the other half after 28 days.
  
  
  METHODS
  Complete resection (all markings included in the specimen), technical success, complication rates, and wound healing on follow-up autopsy and histology.
  
  
  RESULTS
  EFTR of healthy colonic tissue was possible in all cases; 2 additional clips had to be placed for complete closure in 1 case. In 1 animal, the preloaded closure failed, and the animal was prematurely killed. All other animals had an uneventful postoperative course. Necropsy and histopathological evaluation demonstrated well-healed resection sites with no evidence of intra-abdominal infection or inadvertent organ inclusion.
  
  
  CONCLUSIONS
  Animal model, resection of healthy tissue.
  
  
  CONCLUSIONS
  This novel device allows for reliable full-thickness resection and closure of 2-cm specimens of the colonic wall in a single procedure as well as reliable wound healing of EFTR defects.
authors.affiliation: Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany. renteln@gmx.net
authors.forename: Daniel
authors.initials: D
authors.lastname: von Renteln
authors.forename: Thomas
authors.initials: T
authors.lastname: Kratt
authors.forename: Thomas
authors.initials: T
authors.lastname: Rösch
authors.forename: Ulrike W
authors.initials: UW
authors.lastname: Denzer
authors.forename: Guido
authors.initials: G
authors.lastname: Schachschal
mesh_terms: D000818:Animals; D003082:Colectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D003106:Colon / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D005260:Female; D013552:Swine; D058106:Wound Closure Techniques / Q000295:instrumentation*; D014945:Wound Healing