Endoscopic full-thickness suturing has multiple therapeutic applications, including bariatric interventions and gastrointestinal (GI) wall defect closure. However, currently available suturing devices are often complex, difficult to use, or lack robust efficacy data. This study aimed to evaluate the feasibility and performance of a newly developed through-the-scope full-thickness suturing device compatible with a standard 3.2-mm working channel.

A total of six animal experiments were performed to assess the device’s utility for endoscopic sleeve gastroplasty (ESG). All procedures were conducted using a conventional endoscope equipped with the novel suturing system. Procedural success, technical performance, and post-procedural recovery were monitored. Two animals were maintained for 28 days for survival and histologic assessment.

All six ESG procedures were successfully completed using the new device. Animals demonstrated favorable clinical recovery during the observation period. Histologic examination of the two long-term survival animals confirmed the formation of durable full-thickness sutures.

This novel through-the-scope suturing device enables effective full-thickness suture placement and supports successful performance of ESG in an animal model. These results suggest potential utility for bariatric and therapeutic endoscopic applications. Further evaluation in human clinical trials is warranted.