Behind The Knife: The Surgery Podcast Surgical Endoscopy Series Ep. 4: Endoscopic Management of Complications
Jan 19, 2026
Minimally invasive surgeon Zachary Callahan, an associate program director at the University of Tennessee, explores innovative responses to surgical complications. He explains the evolution of endoscopic suturing techniques, including the OverStitch device, and their clinical success. The discussion covers the use of clips for various defects, stent strategies for effective internal drainage, and the EndoVAC's protocol for managing complex conditions. Case studies highlight practical applications, emphasizing the importance of mastering these interventions for optimal patient care.
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Think Endoscopically First
- Learning to think endoscopically broadens options for nonoperative management of complex surgical complications.
- Adding endoscopic skills can reduce conversions to open surgery and lower patient morbidity.
Use OverStitch For Full-Thickness Closure
- Use endoscopic suturing (OverStitch) for full-thickness closures in fresh, viable iatrogenic defects.
- Pair suturing with other tools like stent fixation to prevent migration when indicated.
EMR With Pancreas Exposure Closed Endoscopically
- Zachary Callahan recounts an EMR that left a large duodenal wall defect exposing pancreas.
- He used OverStitch to close it endoscopically and sent the patient home the same day.