Commentary

Several techniques are available for defect closure, including over-the-scope (OTS) [11] [22] and through-the-scope (TTS) [33] [44] devices. However there are still constraints due to the location, size, and/or shape of the defect, endoscopist experience, and the need for scope reinsertion with the device in place [55].

Therefore, I commend the modified endoscopic hand-suturing technique for defect closure introduced by Dou Lizhou et al. This technique, based on TTS introduction of a modified suturing needle with absorbable barbed suture represents a significant step forward, enabling right-colon defect closure after resection without requiring endoscope reinsertion. This advancement could pave the way for new, optimized closure devices for complex anatomical locations.

Endoscopic suturing is a crucial step in expanding the indications for therapeutic endoscopy beyond third-space procedures. To achieve this, it must be rapid, safe, and versatile, reinforcing the essential role of TTS suturing in clinical practice.

Publikationsverlauf

Artikel online veröffentlicht:
25. März 2025

• References

• 1 Kobara H, Mori H, Nishiyama N. et al. Over-the-scope clip system: A review of 1517 cases over 9 years. J Gastroenterol Hepatol 2019; 34: 22-30
• 2 Kantsevoy SV. The development of the Overstitch system and its potentials. Gastrointest Endosc Clin N Am 2020; 30: 107-114
• 3 Abe S, Saito Y, Tanaka Y. et al. A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study. Endoscopy 2020; 52: 780-785
• 4 Canakis A, Deliwala SS, Frohlinger M. et al. Endoscopic outcomes using a novel through-the-scope tack and suture system for gastrointestinal defect closure: a systematic review and meta-analysis. Endoscopy 2024; 56: 605-611
• 5 Ferlitsch M, Hassan C, Bisschops R. et al. Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2024. Endoscopy 2024; 56: 516-545