What is endoscopic suturing?

Endoscopic suturing is a cutting-edge technique that can help treat certain conditions by allowing doctors to place stitches inside the gastrointestinal (GI) tract without the need for traditional surgery. This minimally invasive, low-risk approach results in less discomfort, faster recovery and fewer complications for patients. 

As endoscopic suturing becomes more common in pediatric healthcare, new devices are being developed for use in younger children. Due to the size of current equipment, at this time the technology is best suited for older children and teens. Children’s Hospital of Philadelphia is one of the few pediatric institutions in the country to offer endoscopic suturing. 

When is endoscopic suturing recommended?

Endoscopic suturing has the following applications: 

• Closing tears or leaks in the GI tract after an injury or procedure.
• Repairing abnormal connections, called fistulas, between different parts of the digestive system.
• Treating complications, like bleeding after the removal of large polyps.
• Weight-loss support for adolescents with severe obesity in very specific situations. (Endoscopic suturing is not yet approved as a stomach reduction procedure for children, but CHOP does have FDA approval to study this in adolescents.)

How does endoscopic suturing work?

While your child is under general anesthesia, a small flexible tube called an endoscope is passed through the mouth or rectum into the GI tract. Attached to the endoscope are a tiny camera and a special suturing device. These tools allow doctors to clearly see inside the GI tract and precisely place stitches without any external incisions, leading to faster recovery and less pain.  

For younger children, there is an alternative device, called X-Tack™, that can pass through the tube of the endoscope. This option may make it possible to perform endoscopic suturing in younger (or smaller) patients, expanding the benefits of this procedure to a broader range of children in the future. 

What are the benefits of endoscopic suturing?

Endoscopic suturing has proven to be as a minimally invasive, safe and effective treatment option for a range of GI conditions, with fewer risks and quicker recovery time compared to traditional surgery. More pediatric patients can expect to benefit from this innovative technology in the future.