TIPS ON OVER-THE-SCOPE CLIP USE FOR TREATING GASTROINTESTINAL BLEEDING, PERFORATION AND FISTULA

Abstract

Rescue therapy for gastrointestinal (GI) refractory bleeding, perforation and fistula has traditionally required surgical interventions due to limited performance of conventional endoscopic instruments and technique. A newly developed suturing device, the Over-The-Scope Clip (OTSC) system, can play an important role in rescue therapy. Thus, this innovative device is a final option in endoscopic treatment.

The device has several advantages including a powerful sewing force for GI defect closure with a simple mechanism, and an accessory forceps that can be used to suture a large defect and fistula. Consequently, the OTSC system can provide outstanding clinical effects for rescue therapy. As the procedure of endoscopic closure for perforation and fistula has been newly covered by health insurance in Japan since April 2018, an environment in which the OTSC system can be applied more efficiently has been prepared. Therefore, we here explain useful tips on using the OTSC system in clinical practice.