Endoscopic hemostasis state of the art - Nonvariceal bleeding

Figure 5 Instinct clip. A: Forrest Ib ulcer in the prepyloric antrum; B: After injection of diluted epinephrine solution and clearing of the blood clot a small feeding vessel is identified; C: The instinct clip (Cook Medical, Ireland) is positioned close to the lesion and then the branches are rotated to the desired angle; D: The clip is placed at the basis of the ulcer; E: The clip is closed in a proper position; F: The clip is released and a second clip is positioned on the opposite position.