CLIP CLOSURE FOR POST-GASTRIC ESD ULCERS: A CLIPPING METHOD TO REDUCE SUBMUCOSAL DEAD SPACE FORMATION(WITH A VIDEO)

Abstract

Post-ESD bleeding for gastric cancer in patients receiving antithrombotic agents remains concerning. Conventional clips alone cannot effectively reduce the submucosal dead space (SDS) because of the thickness of the gastric mucosa and muscle layer. This article describes a closure method for post-gastric ESD ulcers using the Mantis clip, featuring sharp anchors and a strong grasping force. The Mantis clip secures the muscle layer while inverting the mucosal defect, enabling rapid SDS-reducing closure with relative simplicity. We detailed the techniques, indications, use, and considerations for post-gastric ESD ulcer closure using the Mantis clip.