X-TACK is a through-the-scope system for tissue approximation in endoscopic procedures. The aim of this study is to describe the efficacy and safety of this device for EMR defects of colorectal lesions.

Retrospective study involving all the patients who underwent EMR for colorectal lesions and the use of x-tack as a suturing device in our center. The primary outcome was technical success. The secondary outcomes were adverse events rates and the rate of using double closure technique.

13 patients were included, 77% male and 23% female, with a mean age of 62 years. The main location where the x-tack was used was the ascending colon, and the mean size of the defect was 40 mm. Regarding to the time spent applying the x-tack, it was 26 minutes. Technical success rate was 100% and there were no adverse events. In 77% of the patients, a double closure technique was needed.

X-tack system is an effective and safe option for tissue approximation of resection defects. However, it has a steep learning curve and in most cases a double closure technique is needed.