Endoscopic Wire-Assisted Closure of Enteric Fistulae

Introduction: Historically, the treatment of enteric fistula required surgical intervention, often exposing patients to complex surgeries and a high risk of fistula recurrence. With advancements in endoscopic therapies, successful closure of enteric fistula using over-the-scope (OTS) clips can be as high as 85%.1 A previous study demonstrated the safety and efficacy of firing OTS clips over a wire, which allows the endoscopist to improve the maneuverability of the endoscope and obtain appropriate apposition of the OTS clip to the fistula opening.2 This video documents two obscure enteric fistulae and the use of a flexible guidewire to facilitate the application of an OTS clip. We demonstrate that firing an OTS clip over a wire is safe, with easy removal of the wire following clip placement.