Effective hemostasis with a self-assembling peptide hemostatic gel to manage leaky hemorrhage at the ulcer closure site after gastric endoscopic submucosal dissection

Intraoperative bleeding is a major complication of endoscopic submucosal dissection (ESD), presenting challenges in identifying the bleeding source and achieving effective hemostasis. Recently, a self-assembling peptide hemostatic gel (PuraStat; 3D Matrix, Tokyo, Japan) was developed as a hemostatic agent that reacts with blood or body fluids to form a hydrogel that coats the bleeding surface [1] [2] [3]. This process results in the occlusion of ruptured vessels, halting bleeding by inducing blood coagulation. Here, we report the successful use of a hemostatic gel in controlling leaky bleeding at a fully closed ESD site where the specific bleeding point could not be identified ([Fig. 1]; [Video 1]).