ASGE-JGES Endoscopic Submucosal Dissection ESD (On-demand) | October 2025-LAB - Advanced ESD Techniques - Closure with X-Tack

LAB - Advanced ESD Techniques - Closure with X-Tack - Othman

Video Transcription

Video Summary

Dr. Muhammad Altman demonstrates the X-TAC device, a through-the-scope tissue approximation tool used to close lesions or defects without removing the endoscope. The device uses four tacks, inserted perpendicularly into tissue folds, which are then cinched together to close gaps. Placement strategies vary by defect size and shape, including figure-eight or Z patterns. Proper technique involves holding the suture correctly to avoid jams and using suction for better positioning. After placing all tacks, the tethers are tightened to approximate tissue folds. X-TAC is particularly useful for large defects, especially in the right colon, often combined with clips for reinforcement.

Keywords

X-TAC device

tissue approximation

through-the-scope

lesion closure

endoscopic suturing