File:PMC5140861 1349-7235-55-3131-g003.png

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Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

Summary

Author:Kazuhiro Furukawa, Ryoji Miyahara, Kohei Funasaka, Takeshi Yamamura, Eizaburo Ohno, Masanao Nakamura, Hiroki Kawashima, Osamu Watanabe,Yoshiki Hirooka, and Hidemi Goto,Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Department of Endoscopy, Nagoya University Hospital{Openi/National Library of Medicine))Source:https://openi.nlm.nih.gov/detailedresult?img=PMC5140861_1349-7235-55-3131-g003&query=Gastrointestinal%20perforation&it=xg&req=4&npos=1 Description:g003: Duodenal ESD and endoscopic closure of gastrointestinal perforation with the OTSC system. a: Although a mixture of glyceol and hyaluronic acid was locally injected into the submucosal layer, the elevation of the lesion was poor, and submucosal dissection was difficult. b: Resection of the lesion by snaring with a circumferential incision resulted in a full-thickness perforation measuring approximately 18 mm in diameter and arterial bleeding from the full thickness resection site. c: The applicator cap with a mounted OTSC clip was attached to the tip of the endoscope. d: The left edge of the perforation was grasped with one jaw of the OTSC Twin Grasper. e: The other jaw of the OTSC Twin Grasper was opened to grasp the right edge of the perforation while grasping the left edge with one jaw. f: The grasped tissue was pulled into the applicator cap, with continuous suctioning. g: The gastrointestinal perforation was endoscopically closed with the OTSC system.