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Zipper repair of colonic perforation with multiple titanium clips under endoscope. (a) An oval perforation about 3 cm in the sigmoid colon. (b) Repair perforation with over-the-scope clip endoscopic clamp-assisted anastomosis and titanium clips in a dual-channel endoscope. (c) Partially repaired perforation. (d) Zipper repair completed.
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Schematic diagram of zipper repairing colonic perforation with a dual-channel endoscope and multiple titanium clips. (a) In one channel, use over-the-scope clip Twin Grasper to grasp one edge of the perforation and bring it close to the opposite edge. (b) Place the first titanium clip to seal the perforation. (c) Repeat step A and prepare to place the second titanium clip to seal the perforation. (d) Repeatedly place multiple titanium clips until the zipper repair process is completed.
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