Advanced Endoscopic Tool Facilitates GI Tract Suturing

The Endo Tools Therapeutics (ETT; Gosselies, Belgium) endomina system is comprised of a tool for tissue piercing and approximation (TAPES) and an universal triangulation platform. It can be affixed to various tested standard endoscopes, providing a bendable therapeutic channel that can move independently. This greater degree of freedom enables gastroenterologists to perform the endoscopic suturing similar to that employed during laparoscopy interventions, but accessing the GI tract via a natural orifice (the mouth), thus providing an incisionless procedure.

The single-use over-the-scope device creates a double plicature of the greater curvature through the use of individual transmural anterior-to-posterior endoscopic sutures that can then be tightened, generating a series of interrupted stitches in the GI tract. The triangulation platform, which permits surgical instruments to be oriented relatively to each other, includes a camera located between two graspers; when the operator desires to place a suture, a bendable loading channel with a pre-loaded tag and tightening system located on one of the graspers generates the force necessary to create the suture.

“ETT’s devices offer new, minimally invasive possibilities for advances in flexible endoscopy. They can be used in a variety of procedures in the digestive tract, such as bariatric interventions. We believe that our technology ideally fits patients’ treatment pathways,” said Alexandre Chau, CEO of ETT. “Developed with physician needs in mind, the endomina system was designed to enable physicians to perform endoscopic suturing similar to laparoscopic procedures, but without an incision.”

“This technology is a very meaningful addition to our armamentarium for performing procedures requiring suturing,” said Ivo Boškoski, MD, of Policlinico Gemelli (Rome, Italy). “The endomina system represents a significant advancement in interventional gastroenterology which could expand treatment options for patients.”

Natural orifice transluminal endoscopy surgery (NOTES) is a surgical technique whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice (mouth, urethra, anus, etc.) and then through an internal incision in the stomach, vagina, bladder or colon, thus avoiding any external incisions or scars.

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