Masterclass Colonoscopy: Trends and Recommendations Forward (Virtual) | February 2024-Closure: When to clip, when not to clip, how to clip, using X-tack

Video Transcription

Video Summary

The presentation discusses the issue of closure after endoscopic resection procedures. The risk of delayed bleeding after resection is influenced by factors such as the size and location of the lesion, as well as factors like anticoagulation and certain medications. The use of closure techniques, such as clipping or suturing, can help reduce the risk of bleeding. Clipping has been found to be effective for large lesions in the proximal colon removed by electrocautery, while closure may not be necessary for smaller lesions or those in the distal colon. Different techniques for clipping are discussed, including the orientation of the clips and the use of specialized clips and sutures. The X-tack and overstitch devices are mentioned as potential options for closure. However, further research is needed to determine their effectiveness. The use of snare tip soft coagulation after cold snare EMR is also discussed, but the need for this technique is not yet supported by evidence and should await further study. Overall, closure techniques have been shown to reduce the risk of bleeding and may be a valuable tool in preventing complications after endoscopic resection procedures.

Asset Subtitle

Douglas K. Rex, MD, MASGE

Meta Tag

Concept Delayed Post-Polypectomy Bleeding

Concept Endoscopic Mucosal Resection

Concept Polyp Removal

Concept Cold Resection

Concept Hot Resection

Keywords

closure

endoscopic resection

delayed bleeding

clipping

suturing

X-tack

overstitch

Delayed Post-Polypectomy Bleeding

Endoscopic Mucosal Resection

Polyp Removal

Cold Resection

Hot Resection