Commentary

10.1055/a-2651-0084

Reliable removal of over-the-scope (OTS) clips typically requires a dedicated direct-current cutter system, which is an additional capital expense and in use requires a warmup time of approximately 10 minutes. For efficiency or because of lack of availability, endoscopists have employed salvage techniques, including argon plasma coagulation and Nd:YAG lasers, to disrupt the clip. Another option includes ice-cold saline lavage that softens nitinol, thus making the clip malleable and allowing its removal. In this video, Lambin et al. demonstrate a novel removal approach using a wire-guided through-the-scope balloon dilator. By inserting the balloon within the loops of the clip and dilating it, the radial hydrostatic force applied to the jaws of the OTS clip facilitates successful disengagement. This technique may offer a widely accessible and safe alternative for OTS clip extraction. Further studies are warranted to establish the clinical outcomes of this approach.

Publication History

Article published online:
22 January 2026