Injection tip method to improve poor visibility during over-the-scope clip procedure

Injection tip method to improve poor visibility during over-the-scope clip procedure Fig. 1 a As the blood clots are aspirated, they become lodged in the forceps hole and ob- struct the field of view.Only a small volume of water is pumped through the waterjet outlet, and the distance between the forceps hole and the waterjet outlet is relatively large, so the blood clots stuck in the forceps hole are not removed.b Pumping water through the forceps hole provides a larger volume, effectively removing the blood clots stuck there. Fig. 2 a The 50-mL syringe (31-mm diameter) cannot fit over the forceps insertion hole because the width of the handwheel is only 21 mm around the forceps insertion hole.This interferes with operating the handwheel.b Although the 5-mL (18-mm diameter) syringe is thinner than the width of the wheel, the distance from the wheel to the forceps insertion hole is only 6 mm.Therefore, the tip of the syringe (radius 9 mm) cannot reach the hole.c A 2-mL (10-mm diameter) syringe can be placed over the forceps insertion hole.However, the over-the-scope (OTS) clip forceps insertion hole is narrower and tighter than a standard one, making it difficult to insert a regular syringe with a 4-mm outer diameter tip.