Endoscopic Full Thickness Suturing of Mucosal, Submucosal and Perforation Defects Using Su2ura® GI System
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Anchora Medical
- Enrollment
- 25
- Locations
- 1
- Primary Endpoint
- Patients with incomplete closure.
Overview
Brief Summary
The objective of this clinical study is to assess the safety of the Su2ura® GI system when used for endoscopic suturing and soft-tissue approximation in patients referred for endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric neoplastic lesions.
The main questions it aims to answer are:
- Percentage of patients with incomplete closure.
- Percentage of patients bleeding at closure site within 28 days from procedure.
- Percentage of patients with infection at closure site within 28 days from procedure.
- Percentage of patients with leakage within 72 hours from procedure.
- Serious Adverse Device Effects (SADE) within 28 days from procedure.
- Overall rates of Adverse Device Effect within 28 days from procedure.
Study includes 6 visits: Screening, Baseline/Surgery, Discharge and 4 weeks, 3 months and 6 months post-surgery. The actual point of enrollment for each subject is considered the day of surgery. Total study duration is up to 6.5 months.
The patient will be admitted to the medical center on the day of the procedure or one day prior for preoperative preparation. Following tissue resection using one of the methods (ESD or EMR), suturing will be performed using the Su2ura® GI system.
Postoperatively, the patient will be transferred to the recovery area and then to the surgical ward for standard monitoring, with an expected one-night postoperative stay and discharge the following day.
Study follow-up visits will take place 4 weeks, 3 and 6 months post surgery.
Detailed Description
This study will be performed in accordance with the design and specific provisions of this protocol, in accordance with the ethical principles that have their origin in the Declaration of Helsinki, that are consistent with Good Clinical Practice (GCP), Title 21 of the Code of Federal Regulations (21 CFR), part 812 (Investigational Device Exemptions), and the applicable regulatory requirements.
The study will be a prospective, single-center, open study, to evaluate the efficacy and safety of the Su2ura® GI System.
The study will be performed at the Tel Aviv Sourasky Medical Center, Israel. Up to 25 patients will be recruited to the study.
Following resection of the lesion using either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), the procedure involves endoscopic insertion of the Su2ura® GI system through the gastroscope working channel, followed by tissue grasping and approximation using sequential deployment of T-Tag Anchors in a predefined suturing pattern. Full-thickness anchors are placed in a controlled manner to achieve safe and effective tissue approximation, after which the suture is secured using the Su2ura® Knot device.
Postoperatively, the patient will be transferred to the recovery area and then to the surgical ward for standard monitoring, with an expected one-night postoperative stay and discharge the following day.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age ≥18 years
- •Patient is able to provide informed consent .
- •Body mass index (BMI) 20-40 kg/m2
- •Patient is referred for endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of a gastric neoplastic lesion
- •Candidate for endoscopic defect closure based on the operating's endoscopist assessment.
Exclusion Criteria
- •Patient with severe comorbidities likely to limit survival to less than 2 years.
- •Patients with INR\>1.5
- •Patients with PLT\< 150
- •Patient with known collagen or connective tissue disorders (e.g. scleroderma, marfan syndrome) .
- •Pregnant women or those intending to become pregnant during the study period
- •Patient with ascites on physical examination or CT scan.
- •Patient with varices.
- •Patient on peritoneal dialysis.
- •Patient with wound-healing disorders.
- •Patient with significant coagulation disorders or those requiring anti thrombotic or anticoagulation treatment other than aspirin .
Arms & Interventions
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Health-related quality of life (HR-QoL) (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Blood Test-Hematology (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Physical Examination (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Vital Signs (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Su2ura® GI system (Device)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Blood Test-Biochemistry (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Urine Pregnancy Test (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Gastroscopy (Diagnostic Test)
Su2ura® GI System-study device group
All participants will undergo endoscopic suturing using a Su2ura® GI System following the ESD or EMR procedure.
Intervention: Visual Analogue Scale (VAS) (Diagnostic Test)
Outcomes
Primary Outcomes
Patients with incomplete closure.
Time Frame: Up to 28 days
Percentage of patients with incomplete closure.
Patients bleeding at closure site.
Time Frame: Up to 28 days
Percentage of patients bleeding at closure site within 28 days from procedure.
Patients with infection at closure site.
Time Frame: Up to 28 days
Percentage of patients with infection at closure site within 28 days from procedure.
Patients with leakage.
Time Frame: Up to 72 hours
Percentage of patients with leakage within 72 hours from procedure.
Serious Adverse Device Effects (SADE)
Time Frame: Up to 28 days
Serious Adverse Device Effects (SADE) within 28 days from procedure.
Overall rates of Adverse Device Effect
Time Frame: Up to 28 days
Overall rates of Adverse Device Effect within 28 days from procedure.
Secondary Outcomes
- Overall rates of Serious Adverse Events(Up to 180 days)
- Serious Adverse Device Effects(Up to 90 days)
- Evidence of a Leak(Up to 30 days)
- Patient Quality of Life(Up to 180 days)