Clinical utility of a novel double-band endoscopic band ligation device for consecutive ligation in the management of diverticular bleeding.

Background and Aims: Endoscopic band ligation is effective for diverticular bleeding; however, conventional devices have drawbacks such as limited visibility, weak suction, and single-use design. Endoligar (Asahi Intecc Co Ltd, Aichi, Japan) addresses these limitations with clear visibility, strong suction, and the ability to perform 2 ligations without removing the endoscope. This report evaluates its clinical utility. Methods: An 82-year-old man with a history of diverticular bleeding was admitted for hematochezia lasting 3 days. Noncontrast computed tomography and emergency colonoscopy suggested a bleeding diverticulum in the ascending colon. A diverticulum at the hepatic flexure showed signs of a recent hemorrhage, but no active bleeding; a clip was placed for marking. On day 8, a second colonoscopy showed oozing from the previously marked diverticulum, and endoscopic band ligation was performed using the novel device. The first band dislodged, but a second ligation was completed without scope removal. Results: The procedure lasted 27 minutes, with minimal bleeding and no adverse events. The patient was discharged on day 13. Conclusions: This is the first clinical case report on this device, to our knowledge. The device enables a second ligation without scope removal, reducing the risk of losing the lesion, and is potentially useful in challenging endoscopic band ligation cases. Further studies are required.