Endoscopic Closure of Gastrointestinal Leaks (DV045) CME EXPIRED-DV045 VIDEO

Video Transcription

Video Summary

This video is a primer on endoscopic management of gastrointestinal perforations and leaks. Dr. Raju from the University of Texas MD Anderson Cancer Center invites viewers to watch the video, which showcases the use of metallic clips for closure of perforations. The video begins by discussing the first reported case of endoscopic closure of a perforation using metallic clips after snare excision of a gastric leomyoma. The patient's successful recovery without the need for surgery is highlighted. The video then demonstrates how to use different clip devices, such as Quick Clip, Tri-Clip, and Resolution Clip. Various animal studies are presented to show the feasibility and success of endoluminal closure of esophageal, gastric, and colon perforations. The video also emphasizes the importance of immediate decompression in cases of tension pneumoperitoneum or pneumothorax. Different techniques for closure of small tears, long tears, gaping tears, and circular holes are demonstrated. The video concludes by discussing the role of endoluminal closure in the management of chronic fistulas and providing an overview of the evidence supporting the use of endoscopic closure for gastrointestinal perforations. The video emphasizes the importance of prevention and training in endoscopic closure techniques. The post-operative management of perforations is also discussed, including the need for close collaboration between endoscopists and surgeons. Overall, this video provides a comprehensive overview of endoscopic management of gastrointestinal perforations and leaks.

Asset Subtitle

Gottumukkala S. Raju, MD, FASGE, University of Texas, MD Anderson Cancer Center, Houston, TX Research support: Pentax Medical Company; Ethicon Endosurgery

Takuji Gotoda, MD, National Cancer Center, Tokyo, Japan

Hisatomo Ikehara, MD, Shizuoka Cancer Center, Shizuoka, Japan

Tonya R. Kaltenbach, MD, Stanford Medical School and VA Medical Center, Palo Alto, CA

Roy M. Soetikno, MD, Stanford Medical School and VA Medical Center, Palo Alto, CA Disclosed no relevant financial relationships.

Keywords

endoscopic management

gastrointestinal perforations

metallic clips

closure

snare excision

animal studies

endoluminal closure

tear closure techniques

chronic fistulas

post-operative management