Variety and clinical applications of endoscopic closure techniques

As endoscopic therapy has progressed, various endoscopic closure techniques have been developed to prevent adverse events and to facilitate complex therapeutic procedures. The development of closure techniques began in the 1970s with the introduction of clipping for mucosal defects after gastric polypectomy. Currently, these techniques are applied primarily to prevent post-procedural bleeding from mucosal defects resulting from endoscopic submucosal dissection; to repair iatrogenic perforations involving full-thickness defects; and to complete endoscopic full-thickness resection. They can be categorized into clipping, tissue apposition, suturing, and stapling, each with distinct advantages and disadvantages. Therefore, familiarity with each method and the ability to select the most appropriate technique for a given situation are essential.