Transparent cap scope tamponade: an inexpensive, efficient, and underappreciated maneuver for bleeding visualization...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Interventional Endoscopy

Background:

• Low-grade bleeding is a common complication during endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).
• Various hemostasis techniques exist, each with limitations.
• A distal attachment offers an underappreciated, efficient method for bleeding control.

Purpose of the Study:

• To highlight the utility of a distal attachment for hemostasis during endoscopic resections.
• To present a simple, cost-effective method for managing intraprocedural bleeding.

Main Methods:

• Utilizing a distal attachment on the endoscope to provide immediate scope tamponade.
• Employing water infusion with the distal attachment to visualize bleeding sources.
• Applying the distal attachment tip directly to the bleeding site for control.

Main Results:

• The distal attachment enhances scope stability during endoscopic resection.
• It facilitates rapid visualization and control of low- to moderate-grade bleeding.
• Four cases demonstrated successful use of the distal cap attachment during colonic EMR.

Conclusions:

• The distal attachment cap is an effective, inexpensive strategy for achieving hemostasis.
• Scope tamponade using the distal attachment is an underappreciated method for intraprocedural bleeding.
• This technique provides immediate control or allows time for definitive hemostatic device retrieval.