Preclipping fixation EMR to achieve sufficient surgical margin and negative resection

Abstract

A 55-year-old man underwent 3-point pre-clipping around a 15-mm ascending colon polyp and conventional EMR for a 12-mm transverse colon polyp. Because magnified narrow-band imaging revealed a slight irregular microvascular pattern at the center depressed area, this ascending colon polyp might have contained a malignant part with high risk for slight submucosal invasion (Fig. 1A) (Video 1, available online at www.giejournal.org). Preclipping to reach the muscular layer was performed (Fig. 1B), and 4 mL of saline solution was injected to ensure ample gripping (Fig. 1C).