Application of the clip method, using thread, for duodenal endoscopic mucosal resection

Endoscopic mucosal resection (EMR) of a duodenal tumour is associated with a risk of loss of the resected specimen resulting from air introduction, peristaltic motion of the intestines, insertion of the retrieval device or endoscopic operation, or in cases where the specimen is too large to pass the pylorus. There is a high possibility of losing the tumour if the resected tumour is passed through the second portion of the duodenum. Retrieving a specimen after EMR is essential to obtain a pathological finding. The clip method using thread has been useful for endoscopic submucosal dissection of the oesophagus and stomach. We report the effectiveness of the clip method using thread during duodenal EMR.