2.6.2. ESD procedure using the S-O clip
ZEOCLIP
A procedural endoscope will be inserted into the colon. After local injection around the lesion, a mucosal incision will be made and submucosal dissection will be performed. If necessary, an additional local injection into the submucosal layer will be performed with the needle or high-frequency knife. After a circumferential incision, the S-O clip will be placed on the lesion. The ZEOCLIP will be used to pull the spring portion of the S-O clip and secure it to the contralateral wall. The number of clips used for traction is indeterminate. If the first S-O clip does not fit properly or detaches during the procedure, it may be reattached as appropriate. After applying traction, the lesion will be dissected and excised while visualizing the submucosal layer. Traction of the lesion is expected to facilitate visualization of the submucosal layer and allow complete resection.