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Closing large mucosal defects after ESD and EMR removal of large sessile adenomas in the proximal colon can be a challenge using standard endoscopic clips. OTSC clips and the overstitch device are not an option for large right colon defects. A suture linked 4 tack wound closure system was introduced recently that allows for approximation of these wound defects. Unfortunately, implantation of the tacks and cinching of the suture is a complex process with many pitfalls. in addition, to reviewing the steps involved with insertion, this video presents the potential problems that may arise with this system and provides solutions and insertion recommendations.
Transcholedochal laparoscopic bile duct exploration is a challenging procedure. Advanced cirrhosis with portal hypertension is associated with unique set of challenges not limited to increased risk of bleeding and fragile liver…
ESD and EMR of large sessile polyps in the right colon results in mucosal defects that, in some cases, cannot be closed with standard clips. OTS clips are not suitable for large wounds and suture linked tack systems are hard to use and not widely used…