The Over-The-Scope Clip (OTSC) for the treatment of gastrointestinal bleeding, perforations, and fistulas

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Abstract
The Over-The-Scope Clip (OTSC®) enables the treatment of patients with gastrointestinal complications such as bleeding, perforations, and fistulas. The aim of this retrospective study was to analyze the therapeutic results of the performed treatments. Since April 2006, 50 patients have been treated for different indications with the OTSC clip in our department. Besides hemostasis (n = 27) in the colon and the upper GI tract, the clip has been used for closure of esophageal and gastric perforations and adaptation of covered and free perforations after colonoscopy (n = 11). Furthermore, the OTSC has been used to close fistulas (n = 8) and for preoperative marking (n = 4). The primary treatment was successful in all cases. There were two secondary bleedings that required endoscopic interventions. Closure of iatrogenic perforations of the upper and lower GI tract was successful in all cases. A permanent closure of fistulas could not be achieved in all cases with the OTSC clip. The OTSC clip is effective and safe for complicated bleeding and closure of perforations of the gastrointestinal tract. Nevertheless, sufficient closure of chronic fistulas with the OTSC still remains an unsolved problem.

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