Novel through-the-scope twin clip for the closure of GI wounds: the first experimental survival study in pigs (with videos)

Background and Aims: We developed a through-the-scope twin clip (TTS-TC) for closing GI wounds. The objective of this study was to evaluate the efficacy and safety of the TTS-TC in GI wound closure. Methods: GI nonperforating and perforating wounds (>= 2.5 cm) were created in live pigs. TTS-TCs were used to convert the large wounds into small wounds. The remaining small wounds were closed using conventional throughthe-scope clips (TTSCs). The follow-up period was 1 month. Location and size of the wound, time of wound closure, intraoperative and postoperative adverse events, and conditions of wound healing were investigated. Results: Thirteen wounds were created in 5 live pigs, including 2 gastric nonperforating and 3 perforating wounds and 5 large intestinal nonperforating and 3 perforating wounds. The mean long and short diameters of the wounds were 4.1 (+/-.9) cm and 3.4 (+/-.7) cm, respectively. All wounds were successfully closed using the TTS-TCs combined with TTSCs. The total mean time for wound closure was 9.2 (+/- 5.3) minutes, and the mean time for using the TTS-TCs was 3.9 (+/- 4.7) minutes. During the 1-month follow-up period, no bleeding, perforation, or death occurred; all wounds healed with scar formation; and all TTS-TCs detached spontaneously. Conclusions: The TTS-TC was successfully used to close large-sized GI wounds. The TTS-TC is a promising tool for large-size wound closure under flexible endoscopy.

Automated summary

The study demonstrated the successful use of TTS-TC for closing large GI wounds, with no significant complications during the 1-month follow-up period. This method provides an effective and safe option for the closure of large-sized wounds under flexible endoscopy.