Recent traction methods for endoscopic submucosal dissection

Figure 3 Schematic of our clip and snare method using a pre-looping technique. A: Endoscope with the prelooped snare; B: The clip was inserted through the working channel of the endoscope and used to grasp the mucosal flap on one side of the lesion; C: The snare, which had been pre-looped over the scope, was loosened and moved along the forceps up to the clip. We tightened the snare to grasp the clip; D: We were then able to release the clip from the forceps (from Ota et al[19]).