Schmidt Arthur, Riecken Bettina, Damm Michael, Cahyadi Oscar, Bauder Markus, Caca Karel
Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany.
Endoscopy. 2014 Sep;46(9):762-6. doi: 10.1055/s-0034-1365493. Epub 2014 Apr 25.
Over-the-scope clips (OTSCs; Ovesco Endoscopy, Tübingen, Germany) are extensively used for treatment of gastrointestinal perforations, leakages, fistulas, and bleeding. In this report, a new method of removing OTSCs using a prototype bipolar cutting device is described.
A total of 11 patients underwent endoscopic removal of an OTSC. The OTSC was cut at two opposing sites by a prototype device (DC ClipCutter; Ovesco Endoscopy). The remaining clip fragments were extracted using a standard forceps.
Mean procedure time was 47 minutes (range 35 - 75 minutes). Cutting of the OTSC at two opposing sites was successful in all cases (100 %). Complete retrieval of all clip fragments was possible in 10 patients (91 %). The overall success rate for cutting and complete removal of the clip was 91 %. No major complications were observed.
Removal of OTSCs with the prototype device was feasible and effective. The device may be valuable for OTSC removal in emergency as well as elective indications.
全层吻合夹（OTSCs；德国图宾根市的Ovesco内镜公司生产）广泛应用于胃肠道穿孔、渗漏、瘘管及出血的治疗。在本报告中，描述了一种使用原型双极切割装置移除OTSCs的新方法。
共有11例患者接受了内镜下OTSCs移除术。使用原型装置（DC ClipCutter；Ovesco内镜公司）在两个相对部位切割OTSC。使用标准镊子取出剩余的夹子碎片。
平均手术时间为47分钟（范围35 - 75分钟）。在所有病例（100%）中，在两个相对部位成功切割OTSC。10例患者（91%）能够完全取出所有夹子碎片。夹子切割及完全移除的总体成功率为91%。未观察到重大并发症。
使用原型装置移除OTSCs是可行且有效的。该装置对于急诊及择期情况下移除OTSCs可能具有重要价值。
