Eagle Claw II: A novel endosuture device that uses a curved needle for major arterial bleeding: A bench study

Bing Hu, S. C.Sydney Chung, Lawrence C.L. Sun, Koichi Kawashima, Tetsuya Yamamoto, Peter B. Cotton, Christopher J. Gostout, Robert H. Hawes, Anthony N. Kalloo, Sergey V. Kantsevoy, Pankaj J. Pasricha

Research output: Contribution to journalArticle

Abstract

Background: Control of bleeding from major arteries in the upper-GI tract remains difficult with currently available endoscopic devices. We designed an endosuture device that uses a curved needle and extracorporeal knotting, and assessed the device in stopping arterial bleeding in a bench model. Methods: Harvested porcine splenic arteries (2-mm diameter) were tunneled submucosally in pig stomach with the open end protruding into an artificially created mucosal defect. The outer end of the vessel was connected to a pulsatile pump, and red ink was infused at a pressure of about 100 mm Hg. The stomach was installed on an Erlangen endo-training model. The suturing device (Eagle Claw II), mounted outside an endoscope, has an eyed, curved needle that carries a 3-0 nylon thread. After puncture, the thread was retrieved by using a hook. Three-throw square knots were tied at the thread extracorporeally and were pushed into place by using a knotting cap. The criteria of successful plication was defined as hemostasis after knotting, no leakage at pressures of >200 mm Hg, and the vessel was completely encircled by the suture. Results: A total of 25 sutures were made with the mean time of 9.38 minutes (standard deviation 1.51). Control of the bleeding was obtained with 17 sutures (68%). The causes for failure were the following: a suture was too shallow (4), a loose knot (2), incorrect suture position (1), and stomach-wall edema (1). Conclusions: Control of bleeding from large arteries by using endoscopic suturing is possible. Continued refinements of the device are required.

Original languageEnglish (US)
Pages (from-to)266-270
Number of pages5
JournalGastrointestinal endoscopy
Volume62
Issue number2
DOIs
StatePublished - Aug 1 2005

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Hu, B., Chung, S. C. S., Sun, L. C. L., Kawashima, K., Yamamoto, T., Cotton, P. B., Gostout, C. J., Hawes, R. H., Kalloo, A. N., Kantsevoy, S. V., & Pasricha, P. J. (2005). Eagle Claw II: A novel endosuture device that uses a curved needle for major arterial bleeding: A bench study. Gastrointestinal endoscopy, 62(2), 266-270. https://doi.org/10.1016/S0016-5107(05)00375-5