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Over-the-scope clip effective in numerous endoscopic scenarios

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HONOLULU — Using the over-the-scope clip in various scenarios, ranging from small perforations to massive bleeds, allows for endoscopic management of traditionally surgical procedures, according to a poster presented at ACG 2015.

 “Traditionally, this clip was used for closure of fistulas, but we have used [it] in multiple settings such as massively bleeding ulcers,” Shivangi Kothari, MD, University of Rochester Medical Center, told Healio Gastroenterology. “If you can avoid surgery by endoscopic closure of perforations or endoscopic control of bleeding, then you’re talking about saving the patient from a lot of morbidity, length of stay and all those downstream effects from the use of the clip.”

Kothari reviewed a rare use of the clip in a large varix in the jejunum in which the patient had “massive” blood transfusions within 24 hours and was still uncontrolled.

“We used a bunch of endoscopic tools and finally we put an over-the-scope clip on the varix and after that, the patient didn’t require any transfusion,” she said. “I wouldn’t say go ahead and put it on every varix, but we have used it in multiple settings from closure of fistulas, closure of perforations and even for massively bleeding vessels and I think that has revolutionized our endoscopic practice for management of all these conditions.”

Taking advantage of available experts and hands-on workshops such as those held at ACG 2015 allow for new users to become comfortable with the technology, Kothari said.

“Endoscopic closure and hemostasis has come a long way and with the new devices coming out, it certainly helps shift the paradigm from surgery to more and more endoscopic management of small perforations and massive bleeds. That paradigm is shifting,” she said. – by Katrina Altersitz 

Reference:

Kothari S. Abstract P234. Presented at: ACG; Oct. 16-21, 2015; Honolulu.

Disclosures: Kothari reports no relevant financial disclosures.