Deployment of a Short, Single-Opening Endoscopic Clip Versus a Long, Reopening Endoscopic Clip in Clinical Practice

Dig Dis Sci. 2015 Aug;60(8):2287-93. doi: 10.1007/s10620-015-3636-6. Epub 2015 Mar 31.

Abstract

Background: Endoscopic clips vary in their designs and costs. Clip wastage is a common problem, and this is dependent on the success of its deployment.

Aims: The aim of this study is to compare the rates of successful deployment between two different commonly used endoscopic clips.

Methods: A single-center, retrospective study was conducted. Endoscopy reports of patients with clips deployed over 24 months were reviewed. We compared a long-pronged, reopening endoscopic clip (type A: Resolution clip; Boston Scientific, Natick, MA, USA) versus a short-pronged, single-opening clip (type B: QuickClip2; Olympus Medical Systems Corp, Japan). The main outcome was clip deployment success rate. Secondary outcomes were predictors of successful deployment, cost, and wastage.

Results: Of 14,690 endoscopic cases, 472 clips (171 type A and 301 type B) were deployed in 262 procedures. Type A clips had a significantly higher successful deployment rate (147/171, 86.0 %) than type B clips (221/301, 73.4 %) (p = 0.002). On multivariate analysis, variables independently associated with successful deployment included using type A clips (OR 2.07, 95 % CI 1.20-3.55; p = 0.009) and clips placed in the lower gastrointestinal tract (OR 3.48, 95 % CI 1.64-7.40; p = 0.001). The cost of using type A clips was higher than type B clips (p < 0.001). Type B clips were associated with more wastage (p = 0.049).

Conclusions: Long-pronged, reopening clips (type A) have a better deployment rate than short-pronged, single-opening clips (type B). Although type A clips had less wastage, the cost per procedure was higher.

Publication types

  • Comparative Study

MeSH terms

  • Colonic Polyps / surgery*
  • Endoscopy / instrumentation*
  • Equipment Design
  • Humans
  • Multivariate Analysis
  • Retrospective Studies