Prefixed purse-string suture used as a new approach to resect a submucosal tumor in the ileocecal region

Perforation is a significant problem that has hindered the development of endoscopic resection techniques. In 2004, Japanese endoscopists introduced the use of nylon rope and titanium clips to close the perforated wound that resulted from endoscopic mucosal resection (EMR) [1]. More recently, endoscopists have considered substituting “active perforation” for “passive perforation” for lesions where perforation is unavoidable. On this basis, we propose a new method for the endoscopic resection of submucosal tumors to avoid intra-abdominal infection and/or tumor seeding.