A novel over-the-scope endoscopic assisting platform for expanding therapeutic capabilities: Preclinical feasibility study (with video)

The limitations of single-channel endoscopy in complex gastrointestinal disease prompted design of the over-the-scope endoscopic assisting platform (OTS-EAP), a low-profile cap that converts any diagnostic endoscope into a dual-channel therapeutic system. Ex-vivo bending tests and in-vivo porcine studies evaluated safety and feasibility for three tasks: 1) high-flow irrigation and suction of clot/chyme; 2) radiation-free, direct-visual stent delivery; and 3) purse-string closure of large endoscopic submucosal dissection defects. OTS-EAP preserved endoscope flexibility and torque; rapid valve-switching cleared the field within seconds, stents were deployed precisely under endoscopic view, and dual-instrument coordination simplified defect closure. The platform offers an inexpensive, radiation-sparing "third hand" for emergencies, bleeding, stenting, and suturing, warranting clinical translation.