A novel endoscopic purse-string suture technique by “loop 9” for gastrointestinal defect closure: a pilot study

Background and study aims: This study aimed to assess the feasibility and efficacy of the novel loop 9 method of gastrointestinal (GI) defect closure. Patients and methods: Twenty patients underwent a GI procedure that required defect closure. Loop 9 can be delivered through a single instrument channel (3.2 mm) and released at the defect site. After being anchored by two clips positioned at the opposite sides of the defect edge, loop 9 was tightened by pulling the end of the suture intraluminally using biopsy forceps. Additional clips were placed to achieve complete closure. The primary outcome was complete closure rate. The secondary outcomes were closure time, sustained closure rate, and adverse events. Results: Complete closure was achieved in 100% of cases. The mean size of the mucosal defects was 17.5 mm (range, 10–55 mm). The median closure time was 14 minutes. The sustained closure rate was 90%. No adverse events were noted. Conclusions: The loop 9 technique is feasible and effective in achieving complete and sustained closure of therapeutic endoscopy-related GI defects.