ASGE DDW Videos from Around the World | 2025-ENDOSCOPIC SUCCESS HEALING A PERFORATED DUODENAL ULCER WITH SUTURING USING THE REOPENABLE CLIP-OVER-THE-LINE METHOD

ENDOSCOPIC SUCCESS HEALING A PERFORATED DUODENAL ULCER WITH SUTURING USING THE REOPENABLE CLIP-OVER-THE-LINE METHOD

Video Transcription

Video Summary

The video discusses an innovative endoscopic approach to treat a perforated duodenal ulcer, especially challenging in patients unfit for surgery. Typically, such ulcers demand surgical or conservative treatments. This case involved a 49-year-old man with heart failure, unable to undergo surgery. The treatment involved multiple endoscopic techniques. Initial suturing attempts failed until the Re-openable Clip Over the Line (ROM) method was used. This method successfully closed and maintained closure of the ulcer, avoiding surgery. The three critical steps were thermal coagulation of the perforation margins, application of a PGA sheet, and suturing with the ROM technique.

Asset Subtitle

Takeshi Yasuda

Keywords

endoscopic approach

perforated duodenal ulcer

Re-openable Clip Over the Line

thermal coagulation

PGA sheet