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Create a Free AccountProcedures - Closure of Perforation/Fistula
Endoscopic full-thickness resection with through-the-scope suture closure for gastrointestinal stromal tumor
Gastrointestinal stromal tumors (GISTs) greater than 2 cm are considered for resection.1 Those with muscularis propria (MP) involvement, as seen on endoscopic ultrasound and/or radiology, require full-thickness resection (FTR), surgery, or a combined laparoscopic/endoscopic approach.2 Dedicated endoscopic FTR (EFTR) devices are available but limited to lesions less than 2 cm.3,4 We present a GIST resected by EFTR and through-the-scope suture (TTSS) defect closure (Video 1, available online at www.giejournal.org ).Endoscopic through-the-scope suturing
There is growing interest in closure of larger mucosal defects, given the increasing use of endoscopic resection for early GI neoplasia and the advent of submucosal endoscopy, including peroral endoscopic myotomy. Existing closure methods include through-the-scope clips, over-the-scope clips, and over-the-scope suturing. Although over-the-scope clips and over-the-scope suturing allow closure of large defects, both require endoscope removal for device application and may have difficulty in treating lesions in the proximal colon or the small intestine.A purely endoscopic management approach for Type V Mirizzi syndrome
A cholecystocolonic fistula (CCF) is a communication between the gallbladder (GB) and the colon. When it coexists with any type of Mirizzi syndrome (MS), this is referred to as Type V MS.1 When it is symptomatic, surgical treatment with cholecystectomy, fistula takedown, and possible colonic resection is indicated.2,3 The role of treatment in asymptomatic patients is unclear. Endoscopic management has not been described.
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