Clip with snare dynamic traction in lesions involving the pyloric ring: pulling and pushing, two ways to go

Abstract Text 76-year-old-woman was referred due to a 30mm gastric Paris 0-Is+IIa lesion in the distal antrum, extending into the proximal bulb.The clip with snare traction technique allowed access to the distal part of the lesion, marking and initial incision, while pushing the snare. During the procedure,pulling the snare allowed the creation of a pocket as well as dissection of the posterior face,while pushing the snare permitted the access to the anterior face.ESD was successful allowing en bloc resection.Using traction on lesions involving the pylorus allows its exposure that would not otherwise be possible. Clip with snare dynamic traction allows bidirectional traction which can be useful in different parts of the procedure.