• Perforation
• endoscopic closure
• endoscopic submucosal dissection
• endoscopic suturing
• over the scope clips

Diagnostic colonoscopy is important for diagnosing colorectal diseases, including inflammatory bowel disease and colorectal tumours. Perforation during diagnostic colonoscopy, a rare but serious complication, is a considerable factor before performing the procedure. Immediate endoluminal closure of a perforation could prevent the adverse consequences associated with general anaesthesia and surgery. This study is aimed at assessing the potential effectiveness and safety of endoscopic band ligation (EBL) in closing a colon perforation during endoscopy in a porcine model.

Colon perforations were created and then subsequently closed with EBL in six porcine models. After 28 days of careful follow-up, pigs were euthanized for clinical and pathologic evaluations.

All colon perforations were successfully closed using EBL in pigs. The mean time of perforation closure with EBL was 244.3 seconds with one to two bands, and there were no immediate complications or clinical manifestations of peritonitis or sepsis in any animals. No pericolonic abscess or peritonitis was found during necropsy. Histopathology demonstrated reepithelialization of the mucosa at the perforation site.

Immediate closure of perforations caused during colonoscopy with EBL is feasible and safe in a porcine model.

Gastrointestinal perforations, which need to be managed quickly, are associated with high morbidity and mortality. Treatments used to close these perforations range from surgery to endoscopic therapy. Nowadays, with the development of new devices and techniques, endoscopic therapy is becoming more popular. However, there are different indications and clinical efficacies between different methods, because of the diverse properties of endoscopic devices and techniques. Successful management also depends on other factors, such as the precise location of the perforation, its size and the length of time between the occurrence and diagnosis. In this study, we performed a comprehensive review of various devices and introduced the different techniques that are considered effective to treat gastrointestinal perforations. In addition, we focused on the different methods used to achieve successful closure, based on the literature and our clinical experiences.

• Gastrointestinal perforations
• Devices
• Techniques
• Endoscopic closure
• Treatment

• Abdominal Injuries/etiology
• Abdominal Injuries/surgery
• Colon/surgery
• Duodenum/surgery
• Endoscopes
• Endoscopy, Gastrointestinal/instrumentation
• Endoscopy, Gastrointestinal/methods
• Esophageal Perforation/etiology
• Esophageal Perforation/surgery
• Esophagus/surgery
• Fibrinogen/chemistry
• Humans
• Intestinal Mucosa/pathology
• Intestinal Perforation/etiology
• Intestinal Perforation/surgery
• Metals/chemistry
• Plastics
• Stents
• Surgical Instruments
• Thrombin/chemistry
• Treatment Outcome

• Colon perforation
• Complication
• Endoscopic band ligation