Shou-jiang Tang Video Journal and Encyclopedia of GI Endoscopy

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Endoscopic Management of Gastrocutaneous Fistula Using Clipping, Suturing, and Plugging Methods Shou-jiang Tang Video Journal and Encyclopedia of GI Endoscopy Volume 2, Issue 2, Pages 55-60 (September 2014) DOI: 10.1016/j.vjgien.2014.03.001 Copyright © 2014 The Author Terms and Conditions

Figure 1 Endoscopic image showing the disruption of the fistula tract lining with an endoscopic device, such as a cytology brush. Removing the necrotic debris within the fistula tract may facilitate tissue growth and fistula closure. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 2 Images showing the through-the-scope clipping devices (A) and their endoscopic deployment for fistula closure by approximating the margins of the fistula opening with multiple clips (C and D). Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 3 Images showing the over-the-scope clipping devices (A) and its endoscopic deployment for fistula closure by approximating the margins of the fistula opening with a single clip device: place the fistula opening at the center of the endoscopic cap (B), apply firm suction through the endoscopic channel allowing the surrounding tissues to be suctioned into the endoscopic cap attachment (C), and deploy the clipping device by turning the firing wheel attached to the endoscope handle (D). Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 4 Images showing trans-abdominal suture placement using an EndoClose device. The endoclose is trying to grasp and retrieve a trans-abdominally placed suture. The suture is held in the left hand of the assistant (A). An endoscopic forceps is used for assistance (B). Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 5 Endoscopic image showing the fibrin sealant is being applied within the fistula tract. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 6 Image showing the biodegradable fistula plugs. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions

Figure 7 Endoscopic image (A) and external view (B) showing the placed biodegradable fistula plug through the fistula tract and it is secured with sutures between the two internal and external buttons. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 55-60DOI: (10.1016/j.vjgien.2014.03.001) Copyright © 2014 The Author Terms and Conditions