Can endoscopic submucosal dissection be safely performed in a smaller specialized clinic?

Figure 3 Representative cases of perforation and bleeding treated endoscopically. A: A perforation was detected (arrows); B: When the omentum became visible through the perforation hole, we attempted to aspirate the omentum through the perforation hole, then clipped the gastric wall and omentum together; C: Several clips were used to seal the hole completely; D: The appearance three months after clipping; E: Bleeding from a post-endoscopic submucosal dissection ulcer was detected; F: After removing the coagulation, the bleeding point was detected; G: Clips were used to achieve hemostasis endoscopically; H: The appearance 1 wk after clipping.