title: DC current pulses for OTSC clip fragmentation: technology and experimental study.
abstract: BACKGROUND
  The OTSC clip is used in endoscopic management of gastrointestinal lesions. In rare cases, the removal of the OTSC clip might be desirable. The objective of the study is to investigate feasibility, efficacy, and safety of a novel endoscopic instrument system for removal of the OTSC clip.
  
  
  METHODS
  The study series has been conducted in a porcine model. Clip removal is performed with a prototype instrumentation that is designed to locally melt the clip by applying an electrical current pulse onto the clip structure. This system has been evaluated in an animal study (n = 10) in a pig model. A cap prototype with an elongated sleeve has been used for extraction of the OTSC clip fragments.
  
  
  RESULTS
  23 of 24 implanted OTSC clips were successfully opened by applying in a total of 74 current pulses. Superficial mucosal coagulation marks were observed in 14 of the 24 application sites. No other findings such as hemorrhage, deep thermal wall lesions, or perforation were observed.
  
  
  CONCLUSIONS
  The study confirms the effectiveness and safety of the proposed endoscopic removal technique. Safe extraction of the clip fragments was feasible with an elongated sleeve at the distal cap. Limitations of the methods are the animal model and the experimental nature of the prototype instrumentation.
authors.affiliation: Division Diagnostic Systems, Ovesco Endoscopy AG, Dorfackerstr. 26, 72074, Tuebingen, Germany, sebastian.schostek@ovesco.com.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schostek
authors.forename: C N
authors.initials: CN
authors.lastname: Ho
authors.forename: M
authors.initials: M
authors.lastname: Melbert
authors.forename: M
authors.initials: M
authors.lastname: Krautwald
authors.forename: A
authors.initials: A
authors.lastname: Caputo
authors.forename: G
authors.initials: G
authors.lastname: Parisi
authors.forename: M
authors.initials: M
authors.lastname: Wehrmann
authors.forename: T
authors.initials: T
authors.lastname: Gottwald
authors.forename: M O
authors.initials: MO
authors.lastname: Schurr
mesh_terms: D000818:Animals; D020878:Device Removal / Q000379:methods*; D004560:Electricity; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D023421:Models, Animal; D013552:Swine