Background:We developed endoscopic injection sclerotherapy with ligation (EISL), which involves EVL of the area including the injection site immediately after injection of the sclerosant into varices, and have used this method since 1993. The usefulness of this method has been documented in our previous reports, but the pneumatic EVL device with a channel for puncture needle, which is commercially available only in Japan, has been required for the method. Recently, a multiple band ligator, with which insertion of puncture needles is possible, has become available internationally. Therefore, we examined the usefulness of the multiple band ligator. Method: The EVL device used was the Injection Speedband Superview(8-band ligator). EISL was performed by the following procedures. A balloon inserted with the EVL device was inflated, EOI was injected into a varix using a needle, and EVL was performed in the area including the injection site, while the needle was kept in place in the varix. The balloon was kept in an inflated state up to the end of operation. The subjects were patients with esophageal varices who were classified as being an F2 (enlarged tortuous varices) red color sign (+1) or more advanced stages, with and without bleeding. Results: Sixteen EISL sessions were performed on 9 patients. The mean EISL session per patient was 1.9±0.3 in this study, while it was 2.1±0.7 in 99 patients who were treated by EISL using the single-band EVL device. The mean time per EISL session was 9.3±2.1 min in this study, which was significantly shorter than that in the 99 patients treated with the single-band EVL device (11.5±3.4). The number of O-ring used per session was 7 at the maximum and 2.8 on average. Therefore, the 8-band ligator was sufficient for treatment. None of the patients had complications. Conclusions: The device used in this study, Injection Speedband Superview, gave visual fields sufficient for the EIS procedure while the device was inserted. The session time was shortened because the procedure can be continuously performed. Furthermore, because the inserted balloon can be kept inflated up to the end of the procedure, outflow of EOI via other varices due to deflation could be prevented. Therefore, this device was proved to be ideal for EISL.