ArticleDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society2023
Twin-grasper assisted mucosal inverted closure achieves complete healing of large perforations after gastric endoscopic full-thickness resection.
Article in Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Through-the-scope twin clip for closure of gastric endoscopic full-thickness resection defects: a retrospective comparative study.Annals of medicine · 2026Article
- Dual-function robotic gripper for traction and closure in gastric endoscopic submucosal dissection: an in vivo porcine model study (with video).Surgical endoscopy · 2025Article
- Endoscopic hand suturing with clips for a large defect after endoscopic full-thickness resection of gastric gastrointestinal stromal tumor.Endoscopy · 2024Article
- Present situation of minimally invasive surgical treatment for early gastric cancer.World journal of gastrointestinal oncology · 2024Review
- A novel twin-grasper assisted mucosal inverted closure technique for closing large artificial gastric mucosal defects.Surgical endoscopy · 2024Article
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesThis study aimed to demonstrate the feasibility and safety of a novel twin-grasper assisted mucosal inverted closure (TAMIC) technique for large perforations after gastric endoscopic full-thickness resection (EFTR) in a porcine model.
methodsIatrogenic large perforations of the stomach were created and closed by an experienced endoscopist using the TAMIC technique in 12 pigs. Repeat gastroscopy was performed in 4 weeks after surgery to examine the wound sites and then the animals were killed. The primary outcomes were the successful TAMIC closure rate and the complete healing rate. Secondary end points included procedure time of TAMIC, complete inverted healing rate, delayed bleeding rate, and postsurgery perforation. Histologies of the wounds were analyzed by hematoxylin-eosin, Masson trichrome, and immunohistochemistry staining.
resultsThe median size of the defects was 3.5 (range 2.5-4.5) cm. TAMIC was successfully performed in all the 12 pigs. Complete healing was achieved in 11 pigs 4 weeks after operation as one pig died postsurgery due to severe pneumonia. The median procedure time for TAMIC was 39 (range 23-81) min. The complete inverted healing rate was 45.5% (5/11). No delayed bleeding or postsurgery perforation was observed. Histologic analyses showed that both the epithelium and muscularis mucosae layers were appropriately connected under inverted healing.
conclusionsTwin-grasper assisted mucosal inverted closure is feasible and safe for closure of large perforations after gastric EFTR and could be a propagable and promising technique for clinical practice.
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