Advances in traction methods for endoscopic submucosal dissection: What is the best traction method and traction direction?

Figure 2 Internal traction method using the spring-and-loop with clip (Zeon Medical, Tokyo, Japan). A: The spring-and-loop with clip (S–O clip) has a 5-mm long spring and a 4-mm long loop at one side of the clip claws; B: The S–O clip is attached to the lesion; C: The regular clip anchors the loop of the S–O clip on the opposite side of the lesion; D: The extension of the spring provides traction on the lesion. Citation: Mitsuru Nagata. Internal traction method using a spring-and-loop with clip (S–O clip) allows countertraction in gastric endoscopic submucosal dissection. Surg Endosc 2020; 34(8): 3722–3733. Copyright © 2020 Mitsuru Nagata[10].