# A Study of a Novel Disposable Endoscopic Purse‐String Suture Auxiliary Instrument for the Treatment of Full‐Thickness Gastric Wall Defects

## TL;DR

A new tool for endoscopic suturing was tested and found to be faster and more effective than traditional methods in closing stomach wall defects in a lab model.

## Contribution

A novel disposable endoscopic purse-string suture auxiliary instrument was developed and shown to improve suturing efficiency and success rates.

## Key findings

- The experimental instrument significantly reduced suturing time compared to traditional methods for both physicians.
- The success rate was higher with the new instrument (100% vs. 75.0%).
- The number of attempts required for successful suturing was significantly lower using the novel device.

## Abstract

In this study, we aimed to evaluate the effectiveness of a novel endoscopic purse‐string suture auxiliary instrument compared with traditional methods for closure of a full‐thickness defect of the stomach in an ex vivo model.

Twelve perforation sites (10–20 mm in diameter) were created in the ex vivo porcine stomach models. Two physicians (A and B had performed endoscopic surgery for 6 and 3 years) performed suturing using both the experimental and traditional (control) instruments. Operation time, success rate, and number of attempts for successful suture required were recorded.

For physician A, the median suturing time was 56.50 s (interquartile range [IQR] 40.50 s, 134.50 s) and 215.50 s (IQR 63.75 s, 254.75 s) in the experimental and control groups. For physician B, they were 53.00 s (IQR 38.50 s, 87.75 s) and 174.00 s (IQR 104.50 s, 279.25 s), respectively. The differences between experimental and control groups were statistically significant for both physicians A (p = 0.010) and B (p = 0.004). The median number of attempts required for successful suturing in the experimental and control groups was 1 (IQR 1, 2) and 2 (IQR 1, 3) for physician A, and 1 (IQR 1, 1) and 3 (IQR 2, 3) for physician B, which were statistically significant for both physicians (p = 0.026 and 0.006). The overall success rate was significantly higher in the experimental group (100% vs. 75.0%, p = 0.022).

This novel purse‐string suture auxiliary instrument may assist in single‐channel endoscopic suturing operations, improve the suture success rate, reduce the number of operations required, and shorten the operation time.

We conducted a full perforation in the ex vivo porcine stomach model, which was closed with a novel endoscopic purse‐string suture auxiliary instrument and a conventional suture instrument, respectively. The effectiveness and feasibility of the novel auxiliary instrument were evaluated. It was found that this device could accelerate the single‐channel endoscopic suturing procedure, improve the success rate of suturing, reduce the number of procedures, and shorten the procedure time.