ASGE Advanced Endoscopic Lesion Resection Course (On-Demand) | 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 careful examination and closure of the defect after polyp resection to prevent complications like recurrence or perforation. They emphasize the need to thoroughly examine the mucosal level for residual polyps and submucosal fibrous tissue, as well as the muscle level for evidence of muscle injury. The speaker also discusses different techniques for closing the defect, including using clips, sutures, or alternative devices like the overstitch or through-the-scope suturing device.<br /><br />The speaker mentions that prophylactic closure with clips has been shown to reduce the risk of delayed bleeding after EMR or ESD procedures. They also discuss various modified clip closure techniques, such as the hole and drag technique, string or suture clip method, and using newer clips like the Mantis Clip or dual-action clips. The speaker also highlights the use of suturing devices, like the overstitch or through-the-scope suturing device, to achieve complete closure of the defect.<br /><br />Overall, the video provides an overview of the importance of closing the defect after polyp resection and discusses different techniques and devices that can be used to achieve complete closure and prevent complications.

Asset Subtitle

Saowanee Ngamruengphong, MD, FASGE

Keywords

careful examination

closure of the defect

polyp resection

complications

recurrence

perforation

techniques for closing the defect

prophylactic closure