A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract:: first clinical experiences

Background: We report on 11 patients with gastric or colonic bleeding or lesions who were treated with a new endoscopic over-the-scope clip (OTSC) system. Objective: The aim of this retrospective analysis was the evaluation of the clinical outcome and description of the new endoscopic device. Design: The data of the patients were evaluated retrospectively. Setting: The OTSC system is composed of an application cap, which is mounted onto the distal tip of the endoscope and a connected releasing mechanism, installed on the handle of the scope. Two different variants of the clip, consisting of a shape-memory alloy (nitinol) are available: the traumatic and the atraumatic versions. In contrast to common endoscopic clips, the OTSC is able to compress larger quantities of tissue. Patients: We treated 11 patients (range, 51-84 years; 8 men, 3 women) with severe bleeding or deep wall lesions, or perforations of the GI tract. Results: All treatments were primarily successful, hemostasis was achieved, and lesions could be closed. We reexamined the patients after the intervention and did not see any complications that could be ascribed to the clip itself or to the applicator cap. Conclusions: The OTSC system is a new tool for the endoscopic compression of tissue. Indications for its use are difficult nonvaricose bleedings and lesions or perforations of the GI tract.