Over-the-Scope Clip in the Management of Gastrointestinal Defect and Intractable Non-Variceal Bleeding

Open Access Recently, as the numbers of diagnostic endoscopic procedures and therapeutic procedures such as endoscopic mu-cosal resection (EMR), endoscopic submucosal dissection (ESD), and full-thickness resection of subepithelial tumors are increasing, the incidence of iatrogenic perforations is also increasing. The use of natural orifice transluminal endoscopic surgery (NOTES) techniques also essentially leads to intentional perforations. Postoperative anatomic and staple line leaks also occur and increase morbidity and mortality. 1 Endo-scopic treatments for such perforations include mechanical closure with through-the-scope (TTS) clips, and sometimes self-expandable metal stents (SEMSs) and band ligation. Recently , TTS clips have been most widely used for repairing deep defects in the gastrointestinal (GI) tract. 2,3 Although TTS clips are relatively easy to use, clipping of large defects and access to the proper position for repairing the defect are difficult. In addition, TTS clips have limited opening widths and closing strengths, and are usually ineffective in the setting of fibrotic tissue.