Over the past 40 years, clinical use of endoclips has been extended from gastrointestinal (GI) hemostasis to the fixation of stents/catheters and for other interventions. Moreover, closure by endoclips are now broadly accepted by endoscopists and considered as the standard treatment of GI perforations for its convenience, avoiding surgical treatment, and reliable outcome [1–6].

Several single-firing devices are available in market: QuickClip2, QuickClip Pro, Resolution Clip, Instinct Clip, and Over-the-Scope Clip (OTSC) [7–9]. Although the multifiring device Clipmaster3 can deploy three clips at a time, the efficacy of this device is not proved as there is no clinical or experimental report [10].

In general, the size of perforation is less than 1.5 cm and it is too big to be closed with only five clips (expect for OTSC, which has a larger size and will need additional procedure for clip...

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