Endoscopic closure of experimental iatrogenic gastric fundus perforation using over-the-scope clips in a surviving canine model.

Abstract

BACKGROUND AND AIM: To evaluate the effectiveness and outcomes of endoscopic closure of a gastric fundus perforation using over-the-scope clips (OTSCs) system in a surviving canine model. METHODS: Gastric fundus perforations (20-mm diameter) were created by an endoscopic needle-knife in six dogs. The perforations then were closed by the OTSC system. Gastroscopy was performed to evaluate the postoperative perforation healing every week. The animals were sacrificed 4 weeks later to examine the possible intraperitoneal complications, and the healing of the perforation was examined histopathologically. RESULTS: The gastric fundus perforations could primarily be closed using one OTSC in each experimental dog, and the mean time of the procedure was 17.3 ± 7.6 min (9-26 min). All animals survived without postoperative complications. The OTSC retention was observed in one dog at the end of 4 weeks, and the apparent foreign-body reaction was examined pathologically. CONCLUSIONS: Our surviving animal study demonstrated that the OTSC clip system could reliably close gastric fundus perforations without complications.