P141 Endoscopic suturing in the upper gastrointestinal tract: a UK case series. (19th June 2022)

• Record Type: Journal Article
• Authors: Aslam, Nasar; Sehgal, Vinay; Hussein, Mohamed; Telese, Andrea; Lovat, Laurence; Haidry, Rehan
• Is Part Of: Gut. Volume 71(2022)Supplement 1
• Page Start: A110
• Page End: A110
• Publication Date: 2022-06-19
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-BSG.197
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: Endoscopic suturing offers a novel technique for deploying full thickness sutures in the gastrointestinal (GI) tract. Indications range from defect closure, stent fixation and tissue plication for obesity. Here we report our experience of endoscopic suturing in the upper gastrointestinal tract using the Apollo OverStitch TM device (Apollo Endosurgery, Austin, Texas). Methods: We retrospectively evaluated cases where the Apollo OverStitch device was used at our tertiary upper GI centre. Patient demographics, indications and outcomes are reported below. Technical success for defect closure was evaluated using on the table fluoroscopy. Results: The Apollo OverStitch device was used a total of 33 times across 23 patients between May 2019 and Feb 2022. (Female = 13, Male = 10) The mean age of patients at the time of the index procedure was 55 (Range 21-77). Outcomes according to indication are highlighted below ( Table 1 ). There was one case of technical failure across the whole case series. This involved a perforation at the junction between D1 and D2 following endoscopic ultrasound. The acute angle impeded the ability to deploy sutures. The defect was successfully closed using clips. Conclusions: Early data from our centre suggests that the Apollo OverStitch device can be used for a diverse range of indications with high rates of immediate technical success and low rates of adverse events. We note that non acute fistulas and defects appear resistant to closure and typically require repeated treatment episodes. We postulate that this may be related tissue epithelisation and/or friability impacting tissue apposition.