A new device for endoscopic band ligation for colorectal diverticular bleeding

Background: Endoscopic band ligation (EBL) has been reported to be effective for colorectal diverticular bleeding. However, current EBL devices have some limitations, and we have developed a novel EBL device. Methods: This novel EBL device has a tapered hood attached to the tip of the endoscope and an outer cylinder that loads two EBL bands. Twelve EBL procedures were performed in a live porcine model alternately using a conventional EBL device (group C) and the novel EBL device (group N). Results: EBL was successful in all cases in both groups. There were no cases of perforation in the 10 days after EBL. After ligation, the mean major axis of the ridge was significantly larger in group N than group C (9.7±1.4mm vs 7.2±1.4mm, P=0.011). Pathological examination revealed disruption of the muscularis propria at 4 of the 6 ligation sites in group C and at 5 of the 6 ligation sites in group N. Conclusions: Using this novel EBL device, it was possible to perform multiple ligation procedures in succession with a good field of view. No perforation was observed, but disruption of the muscularis propria was observed at approximately three-quarters of the ligation sites pathologically.