Clinical Efficacy and Evolving Trends in the Use of Helical Tack Suture System and Endoscopic Suturing System: A Comparative Analysis

The Helical Tack Suture System (HTSS) and Endoscopic Suturing System (ESS) are commonly used in endoscopic procedures. This study compares their clinical efficacy, usage patterns, and outcomes across different gastrointestinal indications. A retrospective analysis of clinical data was conducted. Key metrics included organ site, indication, defect size, procedure time, technical failure, clinical success, additional clip usage, salvage therapy, and adverse events. A total of 241 cases (HTSS: 98, ESS: 143) were analyzed. ESS was primarily used in the stomach (69.2%), while HTSS was more frequently applied in the colon (55.1%) and for endoscopic resection (69.4%), with significant differences in organ distribution (p<0.001). HTSS had a lower clinical success rate (84.6% vs. 94.6%, p=0.020) and required additional clip closure more often (43.9% vs. 26.6%, p=0.006), though technical failure rates were similar. Following HTSS introduction, ESS usage in the colon significantly decreased from 23.1% to 6.6% (p=0.045). HTSS became increasingly preferred for colon and endoscopic resection cases, whereas ESS remained the dominant closure modality for full-thickness defects and third-space entry sites. Selecting the appropriate system based on procedural needs is critical.