Management of bleeding and artificial gastric ulcers associated with endoscopic submucosal dissection

Figure 1 Hemostatic forceps tips. A: Monopolar hemostatic forceps (HDB2422W; Pentax, Tokyo, Japan); B: Bipolar hemostaticforceps (H-S2518; Pentax, Tokyo, Japan); C: Hemostatic forceps (Coagrasper: FD-410LR; Olympus, Tokyo, Japan); D: Hot biopsy forceps (FD-1L-1; Olympus, Tokyo, Japan).

Figure 2 Hemostatic procedure for endoscopic submucosal dissectionintraoperative bleeding using hemostatic forceps. A: Pulsatile bleeding is observed during submucosal dissection; B: By filling the tip attachment with water, the bleeding point can be pinpointed and identified; C: After identifying the bleeding point, the vessel is securely grasped by hemostatic forceps, and thermo-coagulation is performed; D: Complete hemostasis is achieved, without excessive coagulation.