2013 Volume 55 Issue 6 Pages 1854-1863
Full-thickness closure of GI wall defects is a long-cherished dream in the field of flexible endoscopy. A novel clipping device, the Over-The-Scope-Clip (OTSC) system, was developed to enable full-thickness closure for the treatment of GI bleeding, perforations and fistulae. Several studies have demonstrated the clinical feasibility of the OTSC system. However, there are no clinical reports of the use of the OTSC system in Japan. Therefore, we present our inaugural clinical experiences with the use of the OTSC system in 16 cases. Endoscopic OTSC closure was achieved in 14 out of the 16 cases. In 2 cases of bleeding from gastric ulcer, closure of the ulcers was attempted, but failed due to fibrotic changes. There were no clinically significant complications in any of the 14 successfully treated cases, during or after the procedure. Therefore, we believe that the OTSC system would be a useful and safe device for the management of GI bleeding, perforations and fistulae. However, the OTSC system may have some limitations if the target lesions show chronic fibrosis or measure larger than 3 cm in diameter.
