Development and Application of Endoscopic Suturing Devices

In recent years, novel flexible endoscopic approaches in the treatment of refractory intractable gastrointestinal diseases as well as established gastrointestinal diseases have evolved noticeably. The role of endoscopy is to diagnose and treat gastrointestinal diseases including cancer. However, recent developments and advances in flexible endoscopy enable the treatment of unresolved gastrointestinal diseases, as well as those associated with metabolic syndrome, including obesity and diabetes. Suturing is a key modality in surgery, and is considered critical to many procedures in gastroenterology. An essential component of any new endoscopic therapy for applicable diseases is an endoscopic suturing device. The American Society for Gastrointestinal Endoscopy (ASGE) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Working Group at the 2005 Natural Orifice Surgery Consortium for Assessment and Research reported a consensus that successful closure of intentional lumen defects is an absolute necessity for natural orifice transluminal endoscopic surgery (NOTES) to progress and eventually replace other traditional surgical approaches. [1] The development of an endoscopic suture device allows endoscopists to perform minimally invasive endoscopic surgery, NOTES, and endoluminal bariatric procedures with flexible endoscopy. This report discusses the development and application of endoscopic suturing devices with current and future availability.