RESUMO
Las perforaciones del tracto digestivo representan una fuente de morbilidad en la práctica clínica. Clásicamente el manejo de las perforaciones ha sido quirúrgico. En ocasiones, cuando son de pequeño tamaño el tratamiento endoscópico con clips puede resolverla. Sin embargo, la aparición del NOTES (cirugía endoscópica transluminal a través de orificios naturales) ha contribuido de una manera notable a la investigación de nuevas tecnologías que consiguen el cierre endoscópico de las perforaciones del tracto digestivo. Entre ellas el sistema OVESCO, u OTSC (acrónimo del inglés, over the scope clip), constituye por su eficacia, seguridad y rapidez uno de los sistemas más prometedores para el cierre de las perforaciones del tracto digestivo. Otras aplicaciones de este sistema son la hemorragia digestiva grave, las fístulas, los fallos de anastomosis, y su remodelación en la cirugía bariátrica. Este artículo revisa el sistema OVESCO desde su diseño hasta la introducción en la práctica clínica (AU)
Perforations of the gastrointestinal tract are a significant source of morbidity in clinical practice. Surgery has been the standard of care. However, endoscopic treatment with clips can be used when perforations are small. The development of natural orifice transluminal endoscopic surgery (NOTES) has substantially contributed to research in this field, such as the over the scope clip (OVESCO or OTSC). This system is one of the most promising technologies for closure of perforations of the gastrointestinal tract because of its efficacy, safety and rapidity. Other indications include severe gastrointestinal bleeding, fistulae, anastomotic leaks, and bariatric surgery anastomosis remodelling. This article describes the OVESCO system from its initial design to its introduction in clinical practice (AU)
Assuntos
Humanos , Perfuração Intestinal/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Endoscopia Gastrointestinal/métodos , Fístula do Sistema Digestório/cirurgia , Hemorragia Gastrointestinal/cirurgiaRESUMO
Perforations of the gastrointestinal tract are a significant source of morbidity in clinical practice. Surgery has been the standard of care. However, endoscopic treatment with clips can be used when perforations are small. The development of natural orifice transluminal endoscopic surgery (NOTES) has substantially contributed to research in this field, such as the over the scope clip (OVESCO or OTSC). This system is one of the most promising technologies for closure of perforations of the gastrointestinal tract because of its efficacy, safety and rapidity. Other indications include severe gastrointestinal bleeding, fistulae, anastomotic leaks, and bariatric surgery anastomosis remodelling. This article describes the OVESCO system from its initial design to its introduction in clinical practice.
