ASGE Advanced Endoscopic Lesion Resection Course | November 2022-Wrapping it Up: How and When to Close the Defect

Video Transcription

Video Summary

In this video, the speaker discusses the importance of closing defects or perforations after polyp resection in the gastrointestinal tract. They highlight the need to carefully examine the base of the lesion to prevent complications like recurrence or delayed perforation. The speaker discusses the different levels to look at during the examination, including the mucosal level, submucosal level, and muscle level. They explain how to identify and treat residual polyps, blood vessels, and muscle injuries. <br /><br />The speaker also discusses the use of clips for closure and provides data on their effectiveness in preventing complications. They explain how to achieve deep closure and demonstrate different clip techniques, such as the hole and drag technique, string or suture clip method, and modified clip closures using new clip devices. <br /><br />Additionally, the speaker discusses alternative devices for closure, including suturing devices like the overstitch and through the scope suturing device. They explain how these devices can be used to achieve complete closure and provide data on their effectiveness. The speaker concludes by highlighting the importance of a careful inspection of the resection defect and the benefits of prophylactic closure to prevent delayed bleeding.

Asset Subtitle

Saowanee Ngamruengphong, MD, FASGE

Keywords

closing defects

perforations

polyp resection

complications

clip techniques

alternative devices

complete closure

delayed bleeding