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Endoscopic suturing uses an endoscope (a flexible, tube-like imaging instrument) equipped with a stitching device to repair problems in the gastrointestinal (GI) tract. High-definition endoscopes let doctors see inside the body with a high degree of detail and provide treatment at the same time.
Our gastroenterologists (physicians specially trained in treating the GI tract) perform endoscopic suturing in a well-equipped, dedicated outpatient unit. By avoiding open or laparoscopic surgery, patients may have less pain. People often can return to their usual activities within 24 hours.
Endoscopic Suturing: Why It’s Performed
Endoscopic suturing corrects defects of the GI tract such as:
- Fistulas, which are holes or openings in the GI tract
- GI bleeding
- Perforations or tears (which may have resulted from a prior procedure, including bariatric surgery)
Gastroenterologists may use endoscopic suturing in combination with other procedures that are used to remove growths such as colon polyps. These procedures include:
- Endoscopic full thickness resection
- Endoscopic fistula closure
- Endoscopic mucosal resection
- Endoscopic submucosal dissection
- Peroral endoscopic myotomy (POEM)
- Fixing an enteral stent to prevent stent migration
- Repairing a persistent or non-healing benign gastric ulcer
Endoscopic Suturing: How to Prepare
Before endoscopic suturing — whether alone or in combination with another procedure:
- For lower GI tract procedures, follow a liquid diet plus a laxative or enema to cleanse the bowel.
- For upper GI tract procedures, do not eat or drink for 12 hours beforehand, to ensure your esophagus is clear of food products.
- Tell your doctor if you have any allergies.
- Follow your doctor’s instructions about whether to take your prescription medications.
Endoscopic Suturing: What to Expect
On the day of your procedure, you must have a driver who can bring you home. Plan to arrive at the endoscopy unit up to three hours before the procedure. You will register and provide your medical history, including any medications you have taken.
During the procedure, your gastroenterologist will:
- Insert an IV into your vein to deliver a sedative that will make you drowsy.
- Place a high-definition endoscope through your mouth or your anus.
- Use a hand lever on the endoscope to control the special suture device mounted on the tip. Your doctor will observe the images on a screen.
- Pass a corkscrew-like device through the endoscope tube and thread it into the tissue. The corkscrew pulls tissue back into the endoscope tube.
- Use the suture arm’s hooking motion to grab the tissue and place sutures in succession, through the full thickness of the GI wall.
- Close the repair through the endoscope without the need for surgical knots.
Once the procedure is complete, we will monitor your recovery in a recovery room until the sedative wears off. Your doctor will discuss your results with you before you leave.
Common side effects may include:
- Sore throat
- Nausea or vomiting
- Excessive gas, bloating or cramping