Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery

Figure 1 Endoscopic resection of a subepithelial lesion located in the descending duodenum with perforation closure using an over-the-scope clip. A: Endoscopic view of a subepithelial lesion located in the descending duodenum; B: Endoscopic ultrasound evaluation of the same lesion; C: Several marking dots are made around the lesion; D: Injection solution used to elevate the submucosa; E: The mucosa is incised outside the marking dots; F: A circumferential excavation is made as deep as the submucosa around the lesion; G: A duodenal perforation is observed (black arrow) after removal of the lesion; H: The perforation is closed with an over-the-scope clip; I: Healed wound 9 mo after the procedure.