Fig. 3.

Endoscopic images of colonic endoscopic submucosal dissection using clip-with-loops method. (A) An early adenocarcinoma 25 mm in diameter in the transverse colon. (B) After the circumferential incision was performed, poor endoscopic maneuverability prevented the fine visualization of submucosal layer. (C) One side of the loop was anchored to the edge of the lesion using a clip. (D) Another clip was attached to the opposite side of the colon wall while grasping the loop. (E) Good traction was produced, enabling a better submucosal view and safer dissection. (F) En bloc resection was performed.