Skip to main content
Log in

Deployment of a Short, Single-Opening Endoscopic Clip Versus a Long, Reopening Endoscopic Clip in Clinical Practice

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Endoscopic clips vary in their designs and costs. Clip wastage is a common problem, and this is dependent on the success of its deployment.

Aims

The aim of this study is to compare the rates of successful deployment between two different commonly used endoscopic clips.

Methods

A single-center, retrospective study was conducted. Endoscopy reports of patients with clips deployed over 24 months were reviewed. We compared a long-pronged, reopening endoscopic clip (type A: Resolution clip; Boston Scientific, Natick, MA, USA) versus a short-pronged, single-opening clip (type B: QuickClip2; Olympus Medical Systems Corp, Japan). The main outcome was clip deployment success rate. Secondary outcomes were predictors of successful deployment, cost, and wastage.

Results

Of 14,690 endoscopic cases, 472 clips (171 type A and 301 type B) were deployed in 262 procedures. Type A clips had a significantly higher successful deployment rate (147/171, 86.0 %) than type B clips (221/301, 73.4 %) (p = 0.002). On multivariate analysis, variables independently associated with successful deployment included using type A clips (OR 2.07, 95 % CI 1.20–3.55; p = 0.009) and clips placed in the lower gastrointestinal tract (OR 3.48, 95 % CI 1.64–7.40; p = 0.001). The cost of using type A clips was higher than type B clips (p < 0.001). Type B clips were associated with more wastage (p = 0.049).

Conclusions

Long-pronged, reopening clips (type A) have a better deployment rate than short-pronged, single-opening clips (type B). Although type A clips had less wastage, the cost per procedure was higher.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Hayashi T, Yonezawa M, Kuwabara T, Kudoh I. The study on staunch clip for the treatment by endoscopy. Gastroenterol Endosc. 1975;17:92–101.

    Google Scholar 

  2. Hachisu T. Evaluation of endoscopic hemostasis using an improved clipping apparatus. Surg Endosc. 1988;2:13–17.

    Article  CAS  PubMed  Google Scholar 

  3. Hachisu T, Miyazaki S, Hamaguchi K. Endoscopic clip-marking of lesions using the newly developed HX-3L clip. Surg Endosc. 1989;3:142–147.

    Article  CAS  PubMed  Google Scholar 

  4. Hachisu T, Yamada H, Satoh S, Kouzu T. Endoscopic clipping with a new rotatable clip-device and a long clip. Dig Endosc. 1996;8:127–133.

    Article  Google Scholar 

  5. Leung Ki EL, Lau JY. New endoscopic hemostasis methods. Clin Endosc. 2012;45:224–229.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Kirschniak A, Kratt T, Stüker D, Braun A, Schurr MO, Königsrainer A. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc. 2007;66:162–167.

    Article  PubMed  Google Scholar 

  7. Chan SM, Chiu PW, Teoh AY, Lau JY. Use of the over-the-scope clip for treatment of refractory upper gastrointestinal bleeding: a case series. Endoscopy. 2014;46:428–431.

    Article  PubMed  Google Scholar 

  8. Technology Assessment Committee, Chuttani R, Barkun A, Carpenter S, Chotiprasidhi P, et al. Endoscopic clip application devices. Gastrointest Endosc. 2006;63:746–750.

    Article  Google Scholar 

  9. Ginsberg GG, Lipman TO, Fleischer DE. Endoscopic clip-assisted placement of enteral feeding tubes. Gastrointest Endosc. 1994;40:220–222.

    Article  CAS  PubMed  Google Scholar 

  10. Sriram PV, Das G, Rao GV, Reddy DN. Another novel use of endoscopic clipping: to anchor an esophageal endoprosthesis. Endoscopy. 2001;33:724–726.

    Article  CAS  PubMed  Google Scholar 

  11. Baron TH, Gostout CJ, Herman L. Hemoclip repair of a sphincterotomy-induced duodenal perforation. Gastrointest Endosc. 2000;52:566–568.

    Article  CAS  PubMed  Google Scholar 

  12. Luigiano C, Ferrara F, Ghersi S, Fabbri C, et al. Endoclip-assisted resection of large pedunculated colorectal polyps: technical aspects and outcome. Dig Dis Sci. 2010;55:1726–1731.

    Article  PubMed  Google Scholar 

  13. Swellengrebel HA, Marijnen CA, Vincent A, Cats A. Evaluating long-term attachment of two different endoclips in the human gastrointestinal tract. World J Gastrointest Endosc. 2010;2:344–348.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Hwang JH, Fisher DA, Ben-Menachem T, Chandrasekhara V, et al. Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc. 2012;75:1132–1138.

    Article  PubMed  Google Scholar 

  15. Jensen DM, Machicado GA, Hirabayashi K. Randomized controlled study of 3 different types of hemoclips for hemostasis of bleeding canine acute gastric ulcers. Gastrointest Endosc. 2006;64:768–773.

    Article  PubMed  Google Scholar 

  16. Jensen DM, Machicado GA. Hemoclipping of chronic canine ulcers: a randomized, prospective study of initial deployment success, clip retention rates, and ulcer healing. Gastrointest Endosc. 2009;70:969–975.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Daram SR, Tang SJ, Wu R, To SD. Benchtop testing and comparisons among three types of through-the-scope endoscopic clipping devices. Surg Endosc. 2013;27:1521–1529.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric Wee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wee, E., Sachin, M.P., Chinnappa, U. et al. Deployment of a Short, Single-Opening Endoscopic Clip Versus a Long, Reopening Endoscopic Clip in Clinical Practice. Dig Dis Sci 60, 2287–2293 (2015). https://doi.org/10.1007/s10620-015-3636-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-015-3636-6

Keywords

Navigation