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. 2022 Mar 26;22:139. doi: 10.1186/s12876-022-02202-3

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Endoscopic clip closure techniques used in the present study. a Conventional method. Complete closure is achieved with conventional clips by directly bridging the two mucosal rims. b, c Mucosa-submucosa clip closure method. The first clip is placed at the edge of the mucosal defect (b). Additional clips are placed to achieve complete closure (c). d, e, f. Hold-and-drag closure technique. The anal side of the mucosal defect is held with the repositionable clip d. After gently reopening the clip, both edges are grasped (e). The closure is completed using one repositionable clip and several standard clips (f)