Using Hemoclips for Closure of a Complicated Endoscopic Mucosal Resection
Stephen Kim, MD
Clinical Instructor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles, California, USA
The previously identified large 2cm polyp was seen in the cecum. One edge of the polyp appeared to be encroaching on the appendiceal orifice (Figure 2).The polyp was circumferentially lifted (Figure 3).
The Captivator™ II Single-Use Snares, 15 and 20 mm stiff round snares, were then used to remove the polyp in two pieces (Figure 4).
The final endoscopic mucosal resection defect was 2.5cm and showed no evidence of residual polyp and no bleeding or perforation was seen (Figure 5).
Due to the orientation of the polyp and difficult scope position, the hemoclip closure of the endoscopic mucosal resection site was an arduous task. Ultimately, the EMR site was completely closed using careful placement of three Resolution 360™ Clips (Figure 6).