Through-the-scope clip with anchor prongs for defect closure following myotomy, resection, anti-reflux mucosectomy, fistula management, or bleeding
Bibliographic record
Abstract
Background and study aims: Through-the-scope endoscopic clips (TTSCs) are essential for defect closure. A newly designed TTSC with anchor prongs can close defects that were challenging with standard TTSCs. We assessed the safety and efficacy of the TTSC with anchor prongs. Patients and methods: We prospectively studied defect closure using a TTSC with anchor prongs within a multicenter cohort study at 10 sites in six countries. Outcomes were rates of complete defect closure, delayed bleeding, and device- or procedure-related serious adverse events (SAEs). Results: Fifty lesions among 49 participants were studied. Mean age was 55.6 ±16.6 years, and 24 (49.0%) were male. Indications for closure included endoscopic myotomy procedures (n = 21 lesions, 42.0%), bleeding (n = 9, 18.0%), full-thickness resection (n = 7, 14.0%), submucosal tunneling endoscopic resection (n = 6, 12.0%), endoscopic antireflux mucosectomy (n = 3, 6.0%), perforation or closure of non-bleeding fistula (n = 2, 4.0%), and defect closure after removal of embedded plastic biliary stent (n = 2, 4.0%). Complete defect closure was achieved in 49 lesions (98.0%). No delayed bleeding occurred 30 days after the index procedure. Three patients (6.0%) had four related SAEs: ischemic colitis in a participant with a bleeding colonic fistula (1), submucosal leak in a peroral endoscopic myotomy (POEM) procedure (1), and septic shock and mucosal injury associated with a gastric POEM procedure (1). All related SAEs resolved by 10 days after onset. Conclusions: The newly designed TTSC with anchor prongs demonstrated safety and efficacy in defect closures after submucosal interventions, with high rates of successful defect closure and no delayed bleeding. (ClinicalTrials.gov number, NCT05653843).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".