Clips and Loops
Hiroyuki Aihara, MD, PhD
The use of clip in endoscopy was first reported by Hayashi et al in 1975.1 Currently, clips are used for multiple indications including hemostasis for active bleeding, prophylactic mucosal defect closure after endoscopic mucosal resection (EMR), perforation closure, and preoperative marking.
The use of endoscopic loop was first reported by Hachisu et al2 in 1991 for the removal of large pedunculated polyps.
Endoclips (Fig. 37.1)
1. Hemostasis for active bleeding (ulcers, diverticula, etc.)
2. Prophylactic mucosal defect closure after polypectomy or EMR
3. Closure of small gastrointestinal (GI) tract luminal perforations
4. Endoscopic preoperative marking to assist surgical identification
Endoloops (Fig. 37.2)
1. Prevention of post-polypectomy bleeding for pedunculated polyps (Paris Ip)
2. Removal of subepithelial tumors (SETs) with or without retrieval of specimens3