Endoscopic double-layer suture of large gastric defect after endoscopic full-thickness resection

Bing-Rong Liu, Ji-Tao Song. the 2nd affiliated hospital of Harbin Medical University


Successful closure of gastric defects is the key procedure following endoscopic full-thickness resection (EFR). We describe a new endoscopic closure method for large gastric defects after EFR procedure using endoclips, which we call endoscopic double-layer suture technique.


Endoscopic double-layer suture was performed after EFR. The muscular and mucosal layers were sutured separately by using endoclips. The total suture operation time was 19 minutes (the muscular layer suture time was 9 minutes and the mucosal layer suture time was 10 minutes).


Liquid diet resumed 2 hour after the operation in this patient. Follow-up endoscopy 3 day after the procedure showed that the wound healed well without bleeding or fistula.


The use of the double-layer suture method seems to be a safe and feasible procedure for repairing gastric defect left after EFR. We propose endoscopic double-layer suture has more strength than conventional endoscopic closure methods such as endoclips and/or endoloops. Further control study is required.

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