GI Endoscopy · 1 min read

How to close a large defect even if you do not have anchor-pronged clips?

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A recent study published in UEGJ showed the efficiency of closing large defects using an anchor-pronged clip. However, not everybody around the world has this clips available in their unit.

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A recent study published in UEGJ showed the efficiency of closing large defects using an anchor-pronged clip. However, not everybody around the world has this clips available in their unit.

CleanShot 2026-03-10 at 11.49.46@2x.png

In my experience one can close almost any large defect with any types of clips, as long as one utilizes logical closing method, starting from the edges and not in the center of the defect.

Here is our technique:

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  • The first clip is not intended to close the defect

  • Place first clip on the edge of the defect, creating a little bump

  • The second clip is placed next to the bump - the closure begins

  • Have the clips approach the wound „parallel“ and on an inverted „T“ in relation to previous clip

  • With open clip arms press against the wound borders

  • Push clip out, open and pull back towards scope tip

  • Scope tip needs to be close to working area

  • Take your time before releasing clips

CleanShot 2026-03-10 at 11.54.10@2x.png

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