Rocc d 26 195 c

The operation was performed using a single-channel endoscope (GIF-Q260J, Olympus, Tokyo, Japan) and/or a dual-channel endoscope (GIF-2TQ260 M, Olympus). A carbon dioxide insufflator (UCR, Olympus) was used in all procedures. Other equipment and accessories included a high-frequency generator (VIO 200 D, ERBE, Germany), an argon plasma coagulation (APC 2, ERBE), an endoscopic flushing pump (Olympus Medical Systems), a transparent cap (D-201-11804, Olympus Medical Systems), an injection needle (VIN-23, COOK Medical Europe Ltd.), a hook knife (KD-620LR, Olympus Medical Systems), a dual knife (KD-650 L, Olympus Medical Systems), an insulated-tip knife (KD-611 L, IT2, Olympus Medical Systems), sterile hot snare (MTN-PFS-A-28/23, MTN-PFS-E-36/23, Micro-Tech, Nanjing, China), hemostatic clips (ROCC-D-26-195-C, ROCC-F-26-195-C, Micro-Tech, Nanjing, China), and Coagrasper (HBF-23/2000, Micro-Tech, Nanjing, China). A mixed solution of glycerin fructose containing 10% glycerol, 5% fructose, and indigo carmine was used for submucosal injection.

Considering the general condition of the patients, the operators decided to perform bowel preparation using either polyethylene glycol or an enema, and in some cases, no specific bowel preparation was performed. In most cases colonoscopy was performed using a PCF-Q260JI or PCF-H290I scope (Olympus Medical Systems, Tokyo, Japan). Other scopes (CF-Q260AI, PCF-H290Z, PCF-H290TI, or PCF-PQ260L, Olympus Medical Systems; EC-590MP, FUJIFILM, Saitama, Japan) were also used for colonoscopy. The scope was used with a soft cap (D201-10704, D201-11804, D201-12704, or D201-13404; Olympus Medical Systems) and water jet device in all colonoscopies. Endoscopic treatment for CDB with SRH was performed at the discretion of the individual operators. Clipping was predominantly conducted using hemoclips (HX-610-135S or HX-610-135, Olympus Medical Systems; ROCC-D-26-195-C, Micro-Tech, Nanjing, China). These hemoclips were used for the so-called direct method (Fig. 2d), where they were placed on the vessel as close to the bleeding as possible (23 (link)). In contrast, indirect clipping was performed in the Zipper fashion when either the source of the bleeding could not be confirmed due to massive bleeding or it was difficult to insert the clip into the diverticulum (23 (link)).