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. 2023 Jun 23;12(13):4238. doi: 10.3390/jcm12134238

Figure 1.

Figure 1

Schema showing the B-OTSC method. Endoscopic ligation with O-ring closure (a–c). A 2 cm diameter 3-0 surgical nylon loop was anchored at both edges in the center of the post-ESD defect using two hemoclips. Grasping forceps were then used to grasp the loop and pull it into the cap of an endoscopic variceal ligation device, and the deployed hemoclips were then pulled into the cap. An O-ring was fired around the hemoclips to shorten the post-ESD defect. Less than half the circumference (d–f). A 9 mm OTSC was fired using a simple suction technique at the E-LOC site after first adding hemoclips at both ends of the post-ESD defects. Additional hemoclips were used within the OTSC and the gap for complete closure. More than half the circumference (g–i). Two 9 mm OTSCs were placed on both sides of the E-LOC using a simple suction technique. Additional hemoclips were used within the OTSC and the gap for complete closure.