Endoclips


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An endoclip is a metallic mechanical device used in endoscopy in order to close two mucosal surfaces without the need for surgery and suturing. 


It is used to join together two disjointed surfaces, and can be applied through the channel of an endoscope under direct visualization. 


Endoclips used in treating gastrointestinal bleeding, in preventing bleeding after therapeutic procedures such as polypectomy, and in closing gastrointestinal perforations. 


Different shapes and sizes are available, including two and three prong devices


They  can be administered using single use and reloadable systems.


These clips were initially reloadable.


Rotatable clips have been devised to improve localization of deployment.


Clips that open and close, as opposed to single-deployment, have been developed.


Bleeding lesions that have been successfully clipped: peptic ulcers,Mallory-Weiss tears of the esophagus, stomach tumors, and bleeding after removal of polyps.


Endoclips cause less trauma to the mucosa around the ulcer than electrocautery.


Prophylactic clipping of the base of a polyp has been found to be useful in preventing post-polypectomy bleeding, especially in high-risk patients or patients on anticoagulant medications.


Clips can secure the placement of endoscopic feeding tubes, and to orient the bile duct to assist with endoscopic retrograde cholangiopancreatography.


Endoclips dislodge between 1 and 3 weeks from deployment.


However, lengthy clip retention intervals of as high as 26 months have been reported.


Endoclips are safe and not associated with major complications.


Rarely,  perforation or impaction have been reported with them, and  concern about blocking the outflow of the bile duct in the duodenum.





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