Original articleExperimental endoscopyHemodynamic efficacy of the over-the-scope clip in an established porcine cadaveric model for spurting bleeding
Section snippets
Study design
The study was designed as a prospective trial comparing 2 endoscopists of differing expertise (4000 and 10,000 endoscopies performed, both with experience in emergency endoscopy service) to induce hemostasis with the OTSC application device (Ovesco Endoscopy AG, Tübingen, Germany)5 in an established experimental setup with the compact Erlangen Active Simulator for Interventional Endoscopy cadaveric endoscopy simulator equipped with an upper GI organ package for bleeding simulation as described
Results
Complete pressure curves were documented for all 32 bleeding sources. A total of 32 clips were applied. We observed a significant increase in the mean pressure (from 97.6 ± 29.5 mm Hg to 240.5 ± 67.3 mm Hg; P < .001) resulting also in a significant decrease in the mean vessel diameter (19.8 ± 7.4%; P < .001) (Table 1). The maximum recordable pressure was achieved in 19 of 32 bleeding sources (59%).
Discussion
In the underlying experimental study, we tested a new OTSC application device with different properties of other commercially available endoclips designed for use through the working channel of the endoscope. The traditional devices have shown their efficacy in various experimental and clinical prospective trials.8, 9, 10, 11, 12, 13, 14, 15 The mechanism of action of clipping devices is the compression of the vessel by grasping the surrounding tissue. This explains the significantly better
Acknowledgments
We thank Ovesco Endoscopy AG, Tübingen, Germany, for supporting this study by supplying the OTSC devices. Ex vivo specimens and compact Erlangen Active Simulators for Interventional Endoscopy were provided by the Association for Quality-Oriented Training in Endoscopy e.V. Erlangen, a nonprofit organization that aims to research the value of training and testing in endoscopy.
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DISCLOSURE: The following author disclosed a financial relationship relevant to this publication: Dr. Matthes, consultant, Ovesco Endoscopy, USA Inc. The other authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Maiss at [email protected] or [email protected].