Endoscopic hand suturing using a modified through‐the‐scope needle holder for mucosal closure after colorectal endoscopic submucosal dissection: Prospective multicenter study (with video)

• DOI: 10.1111/den.14808
• Publication Date: 2024-05-22T12:29:45Z
• Authors: Takeshi Uozumi; Seiichiro Abe; Yasuhiko Mizuguchi; Masau Sekiguchi; Naoya Toyoshima; Hiroyuki Takamaru; Masayoshi Yamada; Nozomu Kobayashi; Ryo Sadachi; Sayo Ito; Kazunori Takada; Yoshihiro Kishida; Kenichiro Imai; Kinichi Hotta; Hiroyuki Ono; Yutaka Saito
• Keywords: Endoscopic submucosal dissection; Endoscopic mucosal resection

Objectives Endoscopic hand suturing (EHS) is a novel technique for closing mucosal defect after endoscopic submucosal dissection (ESD). We investigated the technical feasibility of colorectal EHS using modified flexible through‐the‐scope needle holder. Methods This was prospective multicenter study conducted at two referral centers between June 2022 and April 2023. included neoplasms 20–50 mm in size located sigmoid colon or rectum. A holder, with an increased jaw width to facilitate grasping, used EHS. The primary end‐points were sustained closure rate on second‐look endoscopy (SLE) performed postoperative days 3–4 time Secondary complete delayed adverse events. Results enrolled 20 patients, including four patients receiving antithrombotic agents. tumor location as follows: lower rectum ( n = 8), upper 2), rectosigmoid 4), 6), median 37 (range, 21–65 mm). 90% (18/20 [95% confidence interval (CI) 68.3–98.8%]), 49 min 23–92 CI 35–68 min]). Sustained SLE 85% (17/20 62.1–96.8%]). No events observed. Conclusion demonstrated high rate. Given long difficulty, should be reserved cases risk