Original ArticleExperimental EndoscopyRandomized controlled study of 3 different types of hemoclips for hemostasis of bleeding canine acute gastric ulcers
Section snippets
Materials and methods
Before starting this comparative study, the 2 endoscopists (D.M.J. and G.A.M.) learned, in a separate pilot study, how to successfully deploy each type of hemoclip. This was first done on a laboratory bench top on tissue models and then endoscopically in dogs. Approximately 8 hemoclips of each type were used; 5 to 6 hemoclips (of each kind) were successfully placed endoscopically in other dogs, before this study was initiated.
For this randomized, prospective study, 7 adult dogs, each weighing
Results
From the pilot study, the investigators observed that there was a short learning curve for each type of hemoclip. Although familiarity with hemoclips was helpful, it did not equate with hands-on experience or successful endoscopic deployment of different types of hemoclips. Because of the different characteristics of hemoclips, as summarized in Table 1, especially in the deployment mechanisms, the GI endoscopist and his assistant had to learn how to successfully deploy each type of clip.
Discussion
Endoscopically deployable hemoclips were initially developed in Japan by Kuramata et al3 and Hayashi et al,4 more than 30 years ago. The early Olympus hemoclips could not be rotated, so that access to some bleeding ulcers was not possible, and deployment was often difficult, especially in emergency cases.3, 4, 5 Over the last 3 decades, Olympus hemoclips have undergone significant technologic improvements, including development of many sizes and shapes of clips, which were reloadable.5, 6, 7
Acknowledgments
The authors thank Jeffrey Gornbein for biostatistical support and Michelle Meadows for the word processing.
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