Procedure of endoscopic detachable snare ligation method for colonic diverticular hemorrhage

Abstract

Colonic diverticular bleeding is the most frequent cause of lower gastrointestinal hemorrhage, and it tends to increase. We previously developed the endoscopic detachable snare ligation (EDSL) method as a new method of endoscopic hemostasis [Endoscopy 2015, 47 (11): 1039-42]. The EDSL method is a method of ligature hemostasis using a transparent hood and an endoloop with a diameter of 20 mm. In this procedure, the endoloop is expanded over the tip of the hood and the hood is pressed against the colonic wall so that the diverticulum is at the center. Then, the endoloop is ligated while sucking the diverticulum into the hood. In the multicenter study conducted by our group, the early rebleeding rate was 7.9% [Gastrointest Endosc 2018, 88 (2): 370-377]. The EDSL method is a useful hemostatic method and may become the first choice among endoscopic hemostasis methods in the future.