A self-made three-arm clip for closure of a large wound after endoscopic full-thickness resection

Effective wound closure is key for a successful endoscopic full-thickness resection (EFTR). The currently available titanium clips can only be used to close wounds of <2 cm [1], the over-the-scope (OTS) clip device requires a series of complex operations [2], and, although the novel through-the-scope twin endoclip (TTS-TC) device is simple and rapid in operation, it is expensive [3]. Based on the principle of the TTS-TC, a three-arm clip (TAC), which is economical, easy to use, and suitable for the closure of large mucosal or submucosal wounds (>3 cm), was made by our team by binding two titanium clips together.