Commentary

Underwater endoscopic mucosal resection (UEMR) of gastrointestinal lesions is gaining increasing attention. Various studies have demonstrated the potential of UEMR and, in certain situations, its superiority over conventional EMR. An interesting application of underwater endoscopy, shown here by Yamamoto & Parra-Blanco, is the complete underwater closure of a UEMR defect. The concept of underwater clipping is easy to understand: when the intestinal lumen is filled with water, the tension on the mucosal defect is considerably reduced. Compared with the situation under gas, the EMR defect shrinks in size and its edges are more easily grasped by the clips, making complete closure easy even in larger-size lesions. Underwater clipping can be applied in all segments of the gastrointestinal tract. Hopefully, this video demonstration will encourage interventional endoscopists to use underwater techniques more often for the benefit of their patients.

Publication History

Article published online:
28 June 2023