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What Are Endoscopic Clips?

Andrew Kirmayer
By Andrew Kirmayer
Updated May 17, 2024
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Endoscopic equipment is often used during various medical tests and treatments involving the digestive tract. In addition to flexible tubes, endoscopic clips are common tools typically for treating ulcers, tears, bleeding, and growths called polyps. An early form was deployed using a metal cable with a hook, and often had to be reloaded each time a clip was used. Pre-loaded versions are often available in different lengths depending on the procedure. Endoscopic clips are often two-pronged, but three-pronged types are sometimes used, as well as ones that can be open and closed before attachment and devices that incorporate multiple clips.

An alternative to injecting or heating an area that is bleeding, endoscopic clips can be used to seal the site. They are also used to mark areas during surgery, treat bleeding ulcers, and seal small arteries. In other cases, the clips can secure feeding tubes to the small intestine, or even close up tears in the gastrointestinal tract.

When using endoscopic clips, a surgeon typically rotates a handle to align the device and squeezes a trigger to open it. The tube, or catheter, the clip is attached to moves through a channel, against body tissue. By squeezing the trigger all the way, the surgeon can close the clip onto the area he or she wants to, and this typically makes a clicking sound or the sensation of one. The device and the catheter normally separate and the rest of the instrument can be removed.

Other types of endoscopic clips can open wider than others. One includes three prongs, which is generally suitable for grasping polyps and other structures. The device does not usually have to be rotated and the clip is typically attached to it; like many other endoscopic clips, this one does not ordinarily re-open by itself. Another kind used during an endoscopic procedure is typically able to open and close so a surgeon can adjust the grasp of the clip.

There are also devices that can hold multiple endoscopic clips, so a few of them can be used during surgery before the system is reloaded. In general, most of the endoscopic devices for deploying clips can seal openings from 0.4 inches to 0.5 inches (about 10 to 12 millimeters) across. During an endoscopy, a surgeon usually approaches the site to be clipped at a low angle, and with a short distance between the tissue and the tip of the scope, for safety.

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