Abstract
Perforation is a severe complication of endoscopic submucosal dissection (ESD), and the incidence is reported to be 2–6%. Appropriate endoscopic repair should be administered immediately to prevent severe complications. As a first step, it is very useful to create a neoplasia-free area around the edges of the perforation with a dual knife. Then this area can be safely closed with endoclips. During the procedure, it is strongly advisable to use CO2 insufflation instead of air to reduce abdominal discomfort. Here, this method is demonstrated in a case with a large perforation that occurred during the ESD procedure. This article is part of an expert video encyclopedia.
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