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. 2023 Feb 28;68(6):2531–2544. doi: 10.1007/s10620-023-07870-z

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial 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-nc/4.0/.

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Fig. 6 — Spring and loop with clip (SLC; S–O clip; Zeon Medical, Tokyo, Japan)-assisted endoscopic submucosal dissection (SLC-ESD). A Interference between the endoscope and spring part of the SLC during submucosal dissection rarely occurs. B After circumferential mucosal incision, the SLC is delivered via the accessory channel of the endoscope and attached to the lesion; C the regular clip captures the loop part of the SLC and then anchors it on the gastric wall; D the traction provides a good field of vision and sufficient tension for the dissection plane (Nagata [31])