{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:02:06Z","timestamp":1767646926343,"version":"3.48.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endoscopic full-thickness resection (EFTR) is a minimally invasive technique for gastrointestinal tract resection and suturing; however, no standardized suturing method has been established. Here, we evaluated a novel endoscopic hand-suturing (EHS) technique, termed \u201cendoscopic full-thickness continuous suturing with stay suture\u201d (EFT-CSS), using SutuArt, an EHS needle holder. This method employs a double-ended needle with V-Loc\u2122 180 suture, enabling continuous full-thickness suturing. Three tests were conducted to compare EFT-CSS with existing methods: Tensile strength test\u2014A 3-cm circular defect in porcine stomach specimens was closed using clip, purse-string suture (PSS), over-the-scope clip (OTSC), and EFT-CSS, each performed thrice. Maximum tensile strength was measured for each closure. Pressure test\u2014A 3-cm circular defect in porcine stomach was closed using OTSC and EFT-CSS, each performed thrice. Air pressure was applied to the defect, and leakage was evaluated underwater. Safety test\u2014A 3-cm circular defect in intestinal models was sutured on an aluminum plate using single- or double-ended needles, each performed thrice. Damage (scratches) on the aluminum plate and suturing time were recorded. EFT-CSS achieved the highest tensile strength (30.57\u2009\u00b1\u20098.90\u00a0N) compared with clip (3.69\u2009\u00b1\u20090.24\u00a0N), PSS (5.86\u2009\u00b1\u20090.32\u00a0N), and OTSC (19.93\u2009\u00b1\u20092.25\u00a0N). Leak pressure was significantly higher with EFT-CSS (54.67\u2009\u00b1\u20097.23\u00a0mmHg) versus OTSC (30.00\u2009\u00b1\u20095.00\u00a0mmHg). Scar area and suturing time were comparable, with reduced scarring observed when using double-ended needles. These results demonstrate that EFT-CSS outperforms conventional methods in strength and safety, offering a promising advancement in EFTR techniques.<\/jats:p>","DOI":"10.1007\/s13304-025-02472-y","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T18:43:11Z","timestamp":1767638591000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic continuous suturing could enhance safety of endoscopic full-thickness resection in ex vivo porcine models"],"prefix":"10.1007","author":[{"given":"Takuya","family":"Hirosuna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-5600","authenticated-orcid":false,"given":"Masaya","family":"Uesato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Nakano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuko","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shutaro","family":"Hike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Kainuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisahiro","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2472_CR1","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1007\/s00464-007-9696-8","volume":"22","author":"N Hiki","year":"2008","unstructured":"Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Miki A, Ohyama S, Seto Y (2008) Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. 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Because the porcine stomach was purchased for food, approval from the Chiba University ethics committee was not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}},{"value":"Not applicable for this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Drs. Takuya Hirosuna, Masaya Uesato, Akira Nakano, Mayuko Kinoshita, Shutaro Hike, Shunsuke Kainuma, and Tetsuro Maruyama, and Prof. Hisahiro Matsubara have no conflicts of interest or financial ties to disclose.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}