Mantis-like claw clip as a rescue therapy for the closure of an unexpected cricopharyngeal mucosal tear during peroral endoscopic myotomy

The closure of an inadvertent mucosal defect during a third-space procedure is mandatory to avoid severe adverse events [1]. Multiple closure methods have been described (endoscopic clips, suture device, cyanoacrylate, over-the-scope [OTS] clip, etc.), with excellent outcomes [2]. However, some anatomic areas such as the cricopharynx can be difficult to close. A recently released mantis-like claw clip named Mantis clip (Boston Scientific, Marlborough, Massachusetts, USA) has shown excellent outcomes in the closure of gastrointestinal defects less than 30mm in size [3] and fixation of esophageal stents [4], even in patients with a high risk of bleeding [5].