Endoscopic puncture-suture device to close gastric wall defects after full-thickness resection: a porcine study

Abstract

Closure of gastric wall defects after endoscopic full-thickness resection remains a clinical challenge. We aimed to introduce an endoscopic puncture-suture device (EPSD) for the closure of such defects. We evaluated the safety, efficacy, and outcomes of the EPSD for closure of gastric wall defects after endoscopic full-thickness resection (EFTR), compared with the metallic clips closure method. Twenty-four Bama mini pigs (20-25 kg) were randomly divided into 2 groups. The EPSD was used in the experimental group and metallic clips were used in the control group. Twelve pigs were randomly assigned to each group. Six pigs underwent EFTR on the anterior wall of the gastric body, whereas the other 6 pigs underwent the same procedure on the posterior wall. The diameter of the resection margin was 2 cm. Either EPSD or metallic clips were applied to close the defects. The duration of the resection and closure, incidence of operative adverse events, and wound recovery were compared and analyzed according to the method of closure. For defects at the same sites, EPSD significantly reduced closure time compared with the metallic clips method (anterior wall, 8 min vs 27.5 min; posterior wall, 7.8 min vs 26.8 min). EPSD is a quick, simple, safe, and effective method to close gastric wall defects after EFTR.