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Animal experiments of a new through-the-scope full-thickness endoscopic suturing device
  1. Mati Shnell1,
  2. Erez Scapa1,
  3. Maria Valeria Matteo2,3,
  4. Hideyuki Chiba4,
  5. Yohei Minato5,
  6. Leon M G Moons6,
  7. Vincenzo Bove2,3,
  8. Shelby Sullivan7,
  9. Ken Ohata5,
  10. Ivo Boskoski2,3
  1. 1Gastroenterology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Tel Aviv, Israel
  2. 2Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy, Italy
  3. 3Universita Cattolica del Sacro Cuore Facolta di Medicina e Chirurgia, Roma, Lazio, Italy
  4. 4Gastroenterology, Omori Red Cross Hospital, Ota-ku, Tokyo, Japan
  5. 5Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
  6. 6Dept of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
  7. 7University of Colorado Denver, Denver, Colorado, USA
  1. Correspondence to Dr Maria Valeria Matteo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy, Italy; mariavaleria.matteo{at}unicatt.it

https://doi.org/10.1136/gutjnl-2024-333298

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    Endoscopic full-thickness suturing has multiple potential therapeutic applications, including bariatric procedures and gastrointestinal (GI) wall defect closure; previous suturing devices have been complex or of unknown or limited efficacy. We present animal results of a new device (the Su2ura GI) used through one instrumentation channel of a conventional endoscope with a 3.2 mm channel. Six animal experiments were performed, and animals did well on follow-up; two animals surviving for 28 days were histologically examined, showing the creation of full-thickness sutures using the Su2ura GI device. This device should be tested further in clinical trials.

    In more details

    In recent years, endoscopic full-thickness suturing has been increasingly used for various procedures, including the treatment of GI perforations, fistulas and anastomotic leaks, closure of full-thickness defects in the GI wall following endoscopic mucosal resection or endoscopic submucosal dissection, fixation of intraluminal stents and gastric remodelling techniques for treating obesity.1–3

    Current full-thickness suturing devices are complex to use, requiring advanced technical skills and significant experience or have unknown or limited efficacy.3–7

    The need for an easy-to-use, through-the-scope and versatile endoscopic suturing device is unmet. We present a new through-the-scope device (the Su2ura GI device) designed for full-thickness sutures in the upper and lower GI tract, with several potential applications and minimal training.

    The sutures are deployed in a simple, intuitive dual-trigger and semiautomatic operation requiring minimal training in endoscopic suites.

    Description of the technology

    The Su2ura GI device is an endoscopic, non-surgical instrument designed to suture through an endoscope channel in both the upper and lower GI tract. The Su2ura GI device is a universal suturing platform that comprises mechanisms for multiple full-thickness T-tag sutures deployment, approximation, re-tightening as needed and thread locking and cutting. It can be affixed to any endoscope with an operative channel of at least 3.2 mm. The device follows the direction of the endoscope.

    The …

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    Footnotes

    • KO and IB are joint senior authors.

    • MS and ES are joint first authors.

    • X @MariaValeriaMat, @ivoboskoski

    • KO and IB contributed equally.

    • MS and ES contributed equally.

    • Contributors MS: concept and design; acquisition, analysis and interpretation of the data, drafting of the article; critical revision of the article for important intellectual content; final approval of the article. ES: concept and design; acquisition, analysis and interpretation of the data, drafting of the article; critical revision of the article for important intellectual content; final approval of the article. MVM: acquisition, analysis and interpretation of the data, drafting of the article; final approval of the article. HC: concept and design; acquisition, analysis and interpretation of the data, final approval of the article. YM: concept and design; acquisition, analysis and interpretation of the data, final approval of the article. LMGM: concept and design; acquisition, analysis and interpretation of the data, final approval of the article. VB: concept and design; acquisition, analysis and interpretation of the data, final approval of the article. SS: concept and design; acquisition, analysis and interpretation of the data, drafting of the article, final approval of the article. KO: concept and design; acquisition, analysis and interpretation of the data, drafting of the article; critical revision of the article for important intellectual content; final approval of the article. IB: concept and design; acquisition, analysis and interpretation of the data, drafting of the article; critical revision of the article for important intellectual content; final approval of the article.

    • Funding This study was funded by Anchora Medical Ltd.

    • Competing interests MS is a consultant for Apollo Endosurgery and Anchora and has stock options from Anchora. SS is a consultant for Biolinq, Bariatek, Endo Tools Therapeutics, Nitinotes, Olympus, Pentax, and Fractyl, has research contracts from Allurion and ReBiotix and has stock options from Elira and Biolinq. IB is a consultant for Apollo Endosurgery, Boston Scientific, Nitinotes, Pentax, Cook Medical, Microtech, ERBE, Siemens, Myka labs and Endo Tools Therapeutics S.A., conducts sponsored lectures for Apollo Endosurgery, Boston Scientific, Cook Medical, Microtech, is recipient of research grant from Apollo Endosurgery, Endo Tool Therapeutics, and ERBE, and is scientific advisory board member for Nitinotes and Myka labs. All other authors have nothing to declare.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.