Fig. 3.

Overstitch System and Over-The-Scope-Clip (OTSC). (A) Although the Overstitch System is an innovative flexible endoscopic full-thickness suturing device with suturing threads, because of its anteriorly directed suture needle, caution should be exercised so as not to cause injury to adjacent organs. Additionally, the OTSC requires two-channel scopes. (B) The OTSC can be attached to a normal multipurpose endoscope and can be used relatively easily. Because it is a clip-type suturing device, which means that it cannot turn back once it is released, caution should be exercised to avoid suture misfire.