Society for Surgery of the Alimentary Tract

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SUTURE LINKED 4 TACK WOUND CLOSURE SYSTEM: INSERTION TIPS AND PITFALLS
Neil Mitra*2, Pablo Palacios2, Hmc Shantha Kumara2, Yanni Hedjar1, Katherine Carsky2, Alya Riaz2, Jeffrey Nussbaum2, Richard L. Whelan2
1Brookdale University Hospital and Medical Center, New York, NY; 2Lenox Hill Hospital, New York, NY

Closing large mucosal defects after ESD and EMR removal of large sessile adenomas in the proximal colon can be a challenge using standard endoscopic clips. OTSC clips and the overstitch device are not an option for large right colon defects. A suture linked 4 tack wound closure system was introduced recently that allows for approximation of these wound defects.
Unfortunately, implantation of the tacks and cinching of the suture is a complex process with many pitfalls. in addition, to reviewing the steps involved with insertion,
this video presents the potential problems that may arise with this system and provides solutions and insertion recommendations.
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