How to help trainees master tri-arm clip wound closure technique after endoscopic surgery as soon as possible

Chen Xue; Zhang Jie

doi:10.3760/j.issn.1673-4777.2026.05.023

Abstract：Objective To explore how to help trainees quickly master the technique of tri-arm clip for wound closure after endoscopic submucosal dissection(ESD)of colorectal lesions.Methods Eight trainees who received standardized ESD training in the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from September 2024 to September 2025 were selected as subjects.A stepwise training model including theoretical lectures,video teaching,on-site observation,animal model practice and hands-on tutoring was adopted.The ability of trainees to independently complete wound closure with tri-arm clips was evaluated.The operation time of wound closure using tri-arm clips combined with ordinary metal clips and the incidence of postop-erative complications such as bleeding,perforation and infection were recorded.After training,questionnaires were used to collect trainees' evaluation and feedback.Results A total of 8 trainees were enrolled and all completed the whole stepwise training process.All trainees could independently complete wound closure with tri-arm clips after ESD.The diameter of the included wounds was(21±8)mm,and the average operation time for trainees to complete wound closure with tri-arm clips combined with ordinary metal clips was(20±11)min.No postoperative complications such as bleeding,perforation or infection occurred in any patient.All trainees reported that the training effect was significant,and the tri-arm clip wound closure technique could effectively improve their ability to manage wounds after ESD.The overall value score of the training in the Likert scale questionnaire was(4.8±0.5).Conclusion The stepwise training model can help trainees quickly master the tri-arm clip wound closure technique after endoscopic surgery.Tri-arm clip is efficient and safe for ESD wound closure,especially suitable for wounds with large area,special anatomical location,intraoperative muscular layer injury or suspected perforation,and high bleeding risk.