ASGE DDW Videos from Around the World | 2026-INNOVATIVE PRE-SUTURED TRANSMURAL CLOSURE (PRESTO) TECHNIQUE TO FACILITATE RAPID FULL-THICKNESS DEFECT SEALING POST-RESECTION

INNOVATIVE PRE-SUTURED TRANSMURAL CLOSURE (PRESTO) TECHNIQUE TO FACILITATE RAPID FULL-THICKNESS DEFECT SEALING POST-RESECTION

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Video Transcription

Video Summary

The PRESTO technique is a novel pre-suture closure method for endoscopic full-thickness resection. In a 64-year-old woman with a gastric low-grade GIST, sutures were placed circumferentially around the lesion before resection. After on-block full-thickness removal, the pre-positioned sutures were cinched immediately, sealing the defect within seconds. A second suture layer reinforced closure. Leak testing was negative, and the patient had no complications. This approach may improve safety, speed, and control in EFTR, especially for difficult lesions or locations where standard post-resection closure is challenging.

Asset Subtitle

Submitted by Anmol Mittal

Keywords

PRESTO technique

endoscopic full-thickness resection

pre-suture closure

gastric GIST

defect closure