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Fabio Garofalo, Maxime Noreau-Nguyen, Ronald Denis, Henri Atlas, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has become a widely accepted option in the treatment of morbid obesity. Gastric leaks after SG occur in .9%-2.2% of the patients, mostly at the gastroesophageal junction. The current treatment algorithm includes drainage, antibiotics, nutritional support, and endoluminal control. OBJECTIVES: Our hypothesis is that long, fully covered stents represent a safe, effective solution for SG leaks. SETTING: University hospital...
December 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Amit Patel, Chris Gillespie, Anthony J Kiosoglous
Anoscrotal fistula is an extremely rare condition involving an epithelialised tract between the anal canal and scrotal wall. It is more commonly seen as a congenital phenomenon in the paediatric population, and has not previously been described in the literature in adults. We present the case of a man aged 52 years who developed a complex anoscrotal fistula after a radical inguinal orchidectomy for an intratesticular seminoma. A postsurgical wound-site infection developed into a chronically discharging wound refractory to antibiotic treatment prompting further investigation...
January 10, 2017: BMJ Case Reports
R L Prosst, A K Joos
BACKGROUND: One hundred consecutive applications of a new clipping device, the OTSC(®) Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas. METHODS: In patients with anorectal fistulas, minimally invasive surgery with the OTSC(®) Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening...
November 2016: Techniques in Coloproctology
Gianfranco Donatelli, Fabrizio Cereatti, Parag Dhumane, Bertrand Marie Vergeau, Thierry Tuszynski, Christian Marie, Jean-Loup Dumont, Bruno Meduri
BACKGROUND: The Over-The-Scope Clip (OTSC®, Ovesco Endoscopy GmbH, Tübingen, Germany) is an innovative clipping device that provides a strong tissue grasp and compression without provoking ischemia or laceration. In this retrospective study we evaluated immediate and long-term success rates of OTSC deployment in various pathologies of the gastrointestinal (GI) tract. METHODS: A total of 45 patients (35 female, 10 male) with an average age of 56 years old (range, 24-90 years) were treated with an OTSC for GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group) or for fistula following abdominal surgery (chronic setting group)...
September 2016: Therapeutic Advances in Gastroenterology
Badr Al-Bawardy, Elizabeth Rajan, Louis M Wong Kee Song
BACKGROUND AND AIMS: Endoscopic full-thickness resection (EFTR) allows for definitive diagnosis and treatment of select subepithelial and epithelial lesions unsuitable to conventional resection techniques. Our aim was to evaluate the efficacy and safety of over-the-scope (OTS) clip-assisted EFTR for these lesions. METHODS: Patients who underwent OTS clip-assisted EFTR between June 2014 and October 2015 were analyzed. The procedure involved (1) thermal marking of the periphery of the lesion; (2) lesion suction into the cap of either an OTSC (Ovesco Endoscopy AG, Tübingen, Germany) or Padlock clip (Aponos Medical Corp, Kingston, NH, USA) with or without triprong anchor retraction of the lesion; (3) clip deployment; and (4) en bloc resection of the lesion above the clip using an electrosurgical snare and/or knife...
May 2017: Gastrointestinal Endoscopy
Phonthep Angsuwatcharakon, Piyapan Prueksapanich, Pradermchai Kongkam, Thawee Rattanachu-Ek, Jaksin Sottisuporn, Rungsun Rerknimitr
Aim. To study the efficacy and other treatment outcomes of Ovesco clip closure of iatrogenic perforation. Methods. Retrospective study from 3 tertiary-care hospitals in Thailand. Patients with iatrogenic perforation who underwent immediate endoscopic closure by Ovesco clip were included. Patients' demographic data, perforation size, number of Ovesco clips used, fasting day, length of hospital stay, success rates, and complication rate were recorded. Technical success was defined as closure achievement during endoscopic procedure and clinical success was defined as the patient can be discharged without the need of additional surgical or radiological intervention...
2016: Diagnostic and Therapeutic Endoscopy
Julián Hernández, Camilo Boza
Bariatric surgery has been considered one of best treatments for obesity. As every surgical procedure-and any medical intervention, it is not exempt of complications, among which leaks, strictures, acute hemorrhages and fistulae highlight. Leaks are more common in the gastro-jejunal anastomosis (GJA) in the case of Roux-en-y Gastric Bypass (RYGB), while in Sleeve Gastrectomy (LSG) they locate in the stapler line. Stenosis can be seen in the gastro-jejunostomy in the RYGB and in the gastric tube in case of the LSG...
2016: Annals of Surgical Innovation and Research
Marius Kryzauskas, Juozas Stanaitis, Rolandas Vaicekauskas, Saulius Mikalauskas
An 83-year-old woman under intravenous anaesthesia underwent endoscopic submucosal dissection due to early well-differentiated colon cancer with no deep invasion (pT1). Wide perforation in the deep site of excision of the descending colon was identified and an Ovesco clip placed to close the defect. The patient was discharged from the hospital on day 4 after the procedure, with no abdominal pain and no peritoneal signs of inflammation. Follow-up CT and colonoscopy were performed after 6 months, and no recurrence was observed...
March 9, 2016: BMJ Case Reports
R Dolezel, O Ryska, M Kollar, J Juhasova, J Kalvach, M Ryska, J Martinek
BACKGROUND: Both over-the-scope clip (OTSC) and KING (endoloop + clips) closures provide reliable and safe full-thickness endoscopic closure. Nevertheless, OTSC clip demonstrated significantly inferior histological healing in the short-term follow-up. AIM: To compare OTSC versus KING closure of a perforation with regard to long-term effectiveness and macroscopic and histological quality of healing. METHODS: We performed a randomized experimental study with 16 mini-pigs (mean weight 43...
March 8, 2016: Surgical Endoscopy
Yurena Caballero, Eudaldo López-Tomassetti, Ana Castellot, Juan Ramón Hernández
Laparoscopic sleeve gastrectomy is currently used for the management of morbid obesity. Gastric fistula is the primary life-threatening complication, and its resolution continues to be a strong challenge for surgeons. Multiple treatment options are available, ranging from conservative therapy to endoscopic use of clips or stents, and even surgical reoperation involving total gastrectomy or conversion to a different bariatric technique. The applicability of each individual option will depend on the type of fistula and the patient clinical status...
November 2016: Revista Española de Enfermedades Digestivas
H-J Richter-Schrag, C Walker, R Thimme, A Fischer
BACKGROUND: The diagnostic validity of a full-thickness resection is higher compared to endoscopic mucosal resection (EMR) or endoscopic mucosal dissection (ESD). Whereas transanal endoscopic microsurgery techniques (TEM, TAMIS) are established therapeutic procedures in the rectum no established and safe minimally invasive or endoscopic procedure exists in the colon. AIM: In this study the novel endoscopic full thickness resection device (FTRD, Ovesco, Germany) was investigated concerning success rates with histologically proven full thickness resections, R0 status as well as patient and device safety for the rectum and colon...
April 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Joshua S Winder, Afif N Kulaylat, Jane R Schubart, Hassan M Hal, Eric M Pauli
INTRODUCTION: Advanced endoscopic techniques provide novel therapies for complications historically treated with surgical interventions. Over-the-scope clips (OTSCs) have recently been shown to be effective at endoscopic closure of gastrointestinal (GI) defects. We hypothesize that by following classic surgical principles of fistula management, a high rate of long-term success can be achieved with endoscopic closure of non-acute GI tract defects. METHODS: A retrospective review of a single-institution prospectively maintained database (2012-2015) of all patients referred for the management of GI leaks or fistulae who underwent attempted closure with the OTSC system (Ovesco, Germany) was performed...
June 2016: Surgical Endoscopy
Radan Keil, Ladislav Douda
Acute upper gastrointestinal tract bleeding is a life-threatening incident in which a right diagnostic and therapeutic approach is necessary. Beside the standards in endoscopic hemostasis (adrenalin injection, hemostatic clips) there are some new technologies in endoscopic hemostasis.
July 2015: Vnitr̆ní Lékar̆ství
Mauro Manno, Santi Mangiafico, Angelo Caruso, Carmelo Barbera, Helga Bertani, Vincenzo G Mirante, Flavia Pigò, Khanna Amardeep, Rita Conigliaro
BACKGROUND AND STUDY AIMS: The over-the-scope clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report a series of patients with high-risk non-variceal upper gastrointestinal bleeding (NVUGIB) lesions in whom OTSCs were used as first-line endoscopic treatment. PATIENTS AND METHODS: We prospectively collected and retrospectively analysed data over a period of 12 months from October 2013 to November 2014 from all consecutive patients who underwent emergency endoscopy for acute severe high-risk NVUGIB and were treated with OTSC as primary first-line therapy...
May 2016: Surgical Endoscopy
Gintautas Radziunas, Audrius Dulskas, Oleg Aliosin, Raimundas Lunevicius, Narimantas E Samalavicius
Anastomotic leak in colorectal surgery is not very unusual. The over-the-scope clipping (OTSC) system (Ovesco), which was originally developed to treat intestinal perforation and was tested with animals, might be the choice for the patient. We presented the case of a 63-year-old man with chronic coloenteric fistula. Conservative treatment was unsuccessful. The orifice was then closed with two subsequent clips, and the patient recovered well. To our knowledge, this is the first successful case of coloenteric fistula treatment with Ovesco...
2015: World Journal of Surgical Oncology
Arthur Schmidt, Peter Bauerfeind, Christoph Gubler, Michael Damm, Markus Bauder, Karel Caca
BACKGROUND AND STUDY AIMS: Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract may be a valuable therapeutic and diagnostic approach for a variety of indications. Although feasibility of EFTR has been demonstrated, there is a lack of safe and effective endoscopic devices for routine use. The aim of this study was to investigate the efficacy and safety of a novel over-the-scope device for colorectal EFTR. PATIENTS AND METHODS: Between July 2012 and July 2014, 25 patients underwent EFTR at two tertiary referral centers...
August 2015: Endoscopy
M Gautier, P Godeberge, R Ganansia, G Bozio, B Godart, M A Bigard, M Barthet, L Siproudhis
BACKGROUND AND AIMS: Closing the internal opening by a clip ovesco has been recently proposed for healing the fistula tract, but, to date, data on benefit are poorly analyzed. The aim was to report a preliminary multicenter experience. MATERIALS AND METHODS: Retrospective study was undertaken in six different French centers: surgical procedure, immediate complications, and follow-up have been collected. RESULTS: Nineteen clips were inserted in 17 patients (M/F, 4/13; median age, 42 years [29-54]) who had an anal fistula: 12 (71%) high fistulas (including 4 rectovaginal fistulas), 5 (29%) lower fistulas (with 3 rectovaginal fistulas), and 6 (35%) Crohn's fistulas...
May 2015: International Journal of Colorectal Disease
D Keren, O Eyal, G Sroka, T Rainis, A Raziel, N Sakran, D Goitein, I Matter
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is currently being widely accepted for its role in the treatment of morbid obesity. Staple-line leakage is one of the most reported complications found in 0.5-7 % of the population, in which the Over-the-Scope Clip (OTSC) (Ovesco Endoscopy, Tübingen, Germany), a novel device, is employed. We present our experience with this system in LSG leaks. METHODS: A retrospective analysis of prospectively collected data from patients with LSG leakage was performed, and these patients were treated with the OTSC system...
August 2015: Obesity Surgery
Gianfranco Donatelli, Jean-Loup Dumont, Bertrand Marie Vergeau, Renaud Chiche, Jean-Jacques Quioc, Thierry Tuszynski, Bruno Meduri
No abstract text is available yet for this article.
November 2014: Therapeutic Advances in Gastroenterology
John Robotis, Andreas Karabinis
Esophageal perforation due to transesophageal echocardiogram (TEE) during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC(®) clip (Ovesco Endoscopy, Tübingen, Germany)...
May 2014: Case Reports in Gastroenterology
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