A technique for preventing clip snagging during the use of a rotating function endoscopic clip

The EZ clip series (Olympus, Tokyo, Japan) is widely recognized as a useful endoscopic clip with a rotating function [1] [2] [3]. This highly effective rotation function allows the clip to be oriented correctly relative to the target ([Fig. 1]). When employing this function, it is crucial to ensure that the coil sheath does not contact the end of the clip, as frictional resistance may impede proper rotation. Thus, separating the coil sheath from the clip is necessary before initiating rotation. The clip is then rotated to the proper angle and then retracted until the clip stopper contacts the coil sheath to allow for clipping. However, excessive bending of the endoscope during angle adjustment may cause the tip of the clip to collide with the coil sheath, leading to clip snagging ([Fig. 2]) and, consequently, imprecise clipping ([Fig. 3]).