Novel reopenable clip with anchor prongs facilitates mucosal defect closure after colorectal endoscopic submucosal dissection: Pilot feasibility study (with video)

Dig Endosc. 2024 Oct;36(10):1164-1170. doi: 10.1111/den.14891. Epub 2024 Jul 28.

Abstract

Closure of mucosal defects following colorectal endoscopic submucosal dissection (C-ESD) is often performed to prevent post-C-ESD adverse events. However, large mucosal defect closure using conventional clips remains technically challenging. Here, we evaluated the feasibility of the novel endoclip with anchor prongs, called the MANTIS Clip (Boston Scientific, Tokyo, Japan), for mucosal defect closure after C-ESD. This high-volume retrospective study was conducted at a single center. From March until December 2023, consecutive patients who underwent post-C-ESD mucosal defect closure using MANTIS Clip to achieve complete closure were enrolled. Patient clinical characteristics and outcomes were evaluated. Closure of the mucosal defect using the MANTIS Clip was attempted following C-ESD in 32 lesions. The median sizes of the resection specimens and the tumors were 32 mm (range, 17-100 mm) and 23.5 mm (range, 5-96 mm), respectively. The lesions were distributed between the cecum, ascending, transverse, descending, sigmoid, and rectum. Complete closure was achieved in 96.9% of cases (31/32). All lesions up to 61 mm in defect size were completely closed. The median closure time was 7.9 (range, 3.3-18.0) min. The median numbers of MANTIS Clip and additional conventional clips were 3 (range, 1-4) and 5 (range, 1-11), respectively. No adverse events associated with closure, post-ESD bleeding, and delayed perforation occurred. MANTIS Clip closure for large post-C-ESD mucosal defects was found to be feasible and reliable with a high complete closure rate and a short procedure time.

Keywords: clip closure; colorectal endoscopic submucosal endoscopic dissection; defect closure.

Publication types

  • Video-Audio Media

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms* / surgery
  • Endoscopic Mucosal Resection* / adverse effects
  • Endoscopic Mucosal Resection* / instrumentation
  • Endoscopic Mucosal Resection* / methods
  • Feasibility Studies*
  • Female
  • Humans
  • Intestinal Mucosa* / surgery
  • Male
  • Middle Aged
  • Pilot Projects
  • Retrospective Studies
  • Surgical Instruments
  • Wound Closure Techniques / instrumentation