Traction assisted closure with tissue inverted clipping strategy (TACTICS) – a novel concept for an efficient full-layer closure in endoscopic full-thickness resection (EFTR) of a gastric GIST – report of a case

Abstract Text The closure of defects after EFTR is usually performed after the resection of a lesion. This implicates several drawbacks: [1] the larger the defect the more difficult it is to grap the margin of the resection area by clips, [2] in case of a full layer defect expansion of the gastric lumen by C0₂ insufflation is not efficient anymore. The concept of TACTICS implicates (a) traction of the lesion by the flexible multifocal snare traction approach for a more efficient resection and (b) alternate closure of the defect by clips or loops before the lesion is fully resected. Transmural defects can be closed more robust and the EFTR procedure becomes more precise and safe. We report a case with a 1.5 cm large GIST which was removed by EFTR using TACTICS and MANTIS clips [3].

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/ee0f6be4-6390-4eb6-abe7-a81f5d204976/Uploads/16849_119917_final.mov

Publication History

Article published online:
27 March 2025

• References

• 1 Tanaka I. et al. VideoGIE. 2024 9 (11). 472
• 2 Fujiyoshi Y. et al. VideoGIE. 2020 5 (7). 274
• 3 Lui et al. Surg Endosc. 2018 32 (5). 2575