Endoscopic Closure of Full-Thickness Gastrointestinal Defects

Although traditionally considered a contraindication to endoscopy, full-thickness GI tract defects now fall well within the realm of the therapeutic endoscopist. An ever-increasing number of devices are available to assist in both definitive and nondefinitive closure as well as in the adjunct therapies required prior to closure. As experience with these tools has expanded, a greater number, larger, and more complex defects are being managed endoscopically. Such closure should be undertaken by advanced therapeutic endoscopists who are capable of performing the interventions outlined in this chapter and often occur within the confines of multispecialty care teams. Ultimately, endoscopic closure of full-thickness GI defects has the potential to eliminate surgical intervention in some patients and offer a chance at closure for patients who have been deemed nonsurgical candidates.