Endoscopic omental packing in combination with the clip-and-snare method using pre-looping technique for gastric perforation.

Endoscopic omental packing (EOP) is a technique used to close gastric perforations and is particularly useful for large defects [1]. We developed the pre-looping technique (PLT) as a simple and safe method of snare delivery into the stomach, and reported applications of the clip-and-snare method using PLT (CSM-PLT) as a traction method for endoscopic submucosal dissection (ESD) [2] [3]. We hereby describe a case where CSM-PLT was used for EOP during intraoperative perforation of gastric ESD.