A Novel Clip Device for Safer and Faster Suturing in Endoscopic Papillectomy: A Retrospective Study of 241 Procedures

Background and Aim: Endoscopic papillectomy (EP) is a minimally invasive treatment for ampullary neoplasms. However, traditional endoscopic clips used for hemostasis and suturing during EP are often difficult to manipulate because of limitations in maneuverability. To address this issue, the efficacy of a novel clip was evaluated for its potential to improve suturing and reduce procedure difficulty after EP. Methods: This retrospective study included 241 patients who underwent EP at Nagoya University Hospital between December 2004 and April 2024. Patients were divided into two groups: the conventional clip group (n = 184) and the novel clip group (n = 57). We compared the total clipping time, number of clips used, and incidence of adverse events between the two groups. Results: The total clipping time was significantly shorter in the novel clip group than in the conventional clip group (6.0 vs. 12.7 min, p < 0.01). The novel clip group also required fewer clips for suturing (3.9 vs. 5.0 clips, p < 0.01) and had fewer dislodged clips at the second look endoscopy (0.05 vs. 0.72 clips, p < 0.01). There was no significant difference in the delayed bleeding rate between the two groups (5.3% vs. 8.7%, p = 0.58). Conclusions: The novel clip demonstrated superior performance in terms of reducing the procedure time, the number of clips used, and the incidence of clip dislodgement in suturing after EP. This offers a promising solution for improving procedural efficiency. In conclusion, the novel clip should be used in wound suturing after EP.