Spychalski M, Orzeszko Z, Kasprzyk P. Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection. World J Gastrointest Endosc 2025; 17(10): 107840 [DOI: 10.4253/wjge.v17.i10.107840]
Corresponding Author of This Article
Zofia Orzeszko, MD, Department of Surgery, Jagiellonian University in Cracow, Trynitarska 11, Krakow 31061, Malopolskie, Poland. zofia.orzeszko@uj.edu.pl
Research Domain of This Article
Gastroenterology & Hepatology
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Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 16, 2025 (publication date) through Oct 19, 2025
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Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Spychalski M, Orzeszko Z, Kasprzyk P. Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection. World J Gastrointest Endosc 2025; 17(10): 107840 [DOI: 10.4253/wjge.v17.i10.107840]
World J Gastrointest Endosc. Oct 16, 2025; 17(10): 107840 Published online Oct 16, 2025. doi: 10.4253/wjge.v17.i10.107840
Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection
Michał Spychalski, Zofia Orzeszko, Przemysław Kasprzyk
Michał Spychalski, Department of General and Oncological Surgery, Medical University of Lodz, Lodz 90647, Lodzkie, Poland
Michał Spychalski, Przemysław Kasprzyk, Center of Bowel Treatment, Brzeziny Specialist Hospital, Brzeziny 95060, Lodzkie, Poland
Zofia Orzeszko, Department of Surgery, Jagiellonian University in Cracow, Krakow 31061, Malopolskie, Poland
Author contributions: Spychalski M conceptualized and supervised the review; Orzeszko Z and Kasprzyk P conducted a literature search, wrote the initial manuscript, and prepared the tables; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zofia Orzeszko, MD, Department of Surgery, Jagiellonian University in Cracow, Trynitarska 11, Krakow 31061, Malopolskie, Poland. zofia.orzeszko@uj.edu.pl
Received: April 1, 2025 Revised: May 25, 2025 Accepted: September 2, 2025 Published online: October 16, 2025 Processing time: 201 Days and 8.3 Hours
Core Tip
Core Tip: Certain resection sites after advanced endoscopic procedures should be considered for endoscopic closure. The choice of closure technique depends on defect size, location, tension, anatomy, cost, and clinician’s proficiency with the device. Traditional techniques like through-the-scope clips and over-the-scope clips are reliable for small to medium defects. Innovative solutions such as the X-TackTM HeliX system, OverstitchTM system, and MANTISTM Clip address larger or high-tension defects. endoscopic hand suturing and OverstitchTM system mimic surgical suturing, offering precise and durable closures for large or irregular defects, though it requires significant operator expertise and time. Combined techniques extend the possibilities for sufficient endoscopic closure.
