title: Over-the-Scope Clip (OTSC) System for Sleeve Gastrectomy Leaks.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is currently being widely accepted for its role in the treatment of morbid obesity. Staple-line leakage is one of the most reported complications found in 0.5-7 % of the population, in which the Over-the-Scope Clip (OTSC) (Ovesco Endoscopy, Tübingen, Germany), a novel device, is employed. We present our experience with this system in LSG leaks.
  
  
  METHODS
  A retrospective analysis of prospectively collected data from patients with LSG leakage was performed, and these patients were treated with the OTSC system. Efficiency was defined as complete oral nutrition without any evidence of additional leakage.
  
  
  RESULTS
  Overall, 26 patients underwent endoscopic OTSC treatment. The median age was 39 years (range 26-60), and 12 were male patients (46.15 %). The mean body mass index (BMI) was 42.89 kg/m(2), and 10 patients (38.46 %) came from a revisional bariatric procedure (SRVG or LAGB). Twenty-two patients (84.61 %) had upper staple-line leaks (near the GEJ), and the remaining 4 (15.38 %) had lower antral leaks. Number of endoscopy sessions ranged from 2 to 7 (median 3). There were five failures: 2 of them had an antral leak, and the remaining 3 had an upper staple-line leak. Twenty-one (80.76 %) leaks were successfully treated within 32 days' median time till complete oral nutrition was attained (range 14-70).
  
  
  CONCLUSIONS
  The success rate was high with the OTSC system, and it is concluded to be a safe and effective treatment for LSG leaks.
authors.affiliation: Department of Gastroenterology, Bnai-Zion Medical Center, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel, dr.deankeren@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Keren
authors.forename: O
authors.initials: O
authors.lastname: Eyal
authors.forename: G
authors.initials: G
authors.lastname: Sroka
authors.forename: T
authors.initials: T
authors.lastname: Rainis
authors.forename: A
authors.initials: A
authors.lastname: Raziel
authors.forename: N
authors.initials: N
authors.lastname: Sakran
authors.forename: D
authors.initials: D
authors.lastname: Goitein
authors.forename: I
authors.initials: I
authors.lastname: Matter
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000453:epidemiology / Q000517:prevention & control*; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013525:Surgical Instruments; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome