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Targeted Technology Assessment. Closure Devices. Closure. Suturing Stapling Clipping SEMF Miscellaneous Tissue adhesives Tissue welding. Suturing. Device, low profile, in continuity with the endoscope Set-up in minutes ( < 10) Device functionality Allows access Permits orientation
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Targeted Technology Assessment Closure Devices
Closure • Suturing • Stapling • Clipping • SEMF • Miscellaneous • Tissue adhesives • Tissue welding
Suturing • Device, low profile, in continuity with the endoscope • Set-up in minutes (< 10) • Device functionality • Allows access • Permits orientation • Accurate placement with sufficient force; supplemental tissue grasper • Closure, non-knot dependent • Simple operation • Single operator +/- assistant • Single intubation
Suturing cont’d • Curved needle allowing full thickness stitch • Non-absorbable and absorbable suture monofilament • Minimal chance for device failure • Intralumenal & peritoneal applications • Multiple device variations may be needed for different applications, including needle designs
Stapling • Independent flexible device • Endoscope channel vs. “eyes” • Linear, articulating end • Single firing acceptable • Controlled T-tag (end plate) • Attached suture
Clips • Both single (conventional) and clasp-type acceptable • Clasp-type • Controlled closure • Conventional • Multiple/device • Clip tip variation: needle, serrated • Large size acceptable