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Depending on the direction of the endoscope, operators should be aware of interference between the endoscope axis and spring. A, The spring may interfere with the endoscope in the retroflexed position. The S-O clip should be anchored on the site where the spring does not interfere with the endoscope axis. B, Interference between the endoscope axis and spring during submucosal dissection rarely occurs in the forward position, unlike in the retroflexed position.
