OverStitch Sx Endoscopic suturing system in minimally invasive endoscopic procedures: overview of its safety and efficacy and comparison to oversticth^TM

ABSTRACT

Introduction

OverStitch endoscopic suturing enables advanced closure by tissue approximation via endoscopically placed sutures with the ability to customize suture patterns. Newer OverStitch generation also known as OverStitch Sx overcame the limitation of the previous generation and is compatible with 20 single channel scopes over four platforms with greater maneuverability and visibility.

Areas covered

In this article we will focus on the differences between three generations of OverStitch. In addition, we will review existing literature on the efficacy of OverStitch in the management of full thickness defect closure, fistula and leaks repair, stent fixation, and bariatric surgeries along with its complications and limitations.

Expert opinion

Assembling overstitch takes less than five minutes and the correct sequence of system assembly is the key for a successful procedure. Transition from the second-generation OverStitch to OverStitch Sx may require three to five cases for learning curve.

KEYWORDS:

• Endoscopic suturing
• full thickness closure
• fistula repair
• bariatric
• troubleshooting

Article Highlights

• OverStitch Sx, which is compatible with Olympus, Pentax Medical, Fujifilm, and Storz and can be easily assembled over 20 single-channel flexible endoscopes.

• Tower height is slightly larger in OverStitch Sx and the exit port for the tissue helix is located on the side (centrally located in OverStitch gen-2 design) providing more flexibility in different dimensions and improving the angle of visualization.

• Endoscopic suturing with OverStitch has shown to have widespread application including full thickness defect closure, fistula/leak repair, stent fixation, and gastrointestinal bleeding management.

• Primary endoscopic sleeve gastroplasty and subsequent gastric pouch reduction and Endoscopic gastrojejunal revision using OverStitch are minimally invasive weight loss interventions and lead to a paradigm shift from surgical interventions.

• Learning curve from overstitch TM to overstitch SX may require three to five cases.

• Working from 1 cm away from the lesion and using tissue grasper with each bite facilitate suturing with OverStitch Sx device.

Declaration of Interest

M Othman is a consultant for Olympus, Boston Scientific, Apollo, AbbVie, and Lumendi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

One peer reviewer is an international consultant for Apollo Endosurgery, the manufacturer of the device. Another peer reviewer has received an Apollo Endosurgery research Grant; is an EndoTools Advisory board member; and has done consultancy for Boston Scientific. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was not funded.