Narrow endoscopic view through the rubber band delivery attachment placed on the tip of the endoscope. The variceal banding technique is similar to hemorrhoid banding and involves placing small elastic bands around varices in the distal 5 cm of the esophagus. Varices are suctioned into the banding device and bands are released around the base of the varix by pulling a trip wire via the biopsy channel. The advantages of band ligation over sclerotherapy include fewer local complications (secondary bleeding from ulcers or strictures), no systemic side effects, and the need for fewer treatments for variceal obliteration. Some of the drawbacks of band ligation include a restricted endoscopic view (due to the banding device and blood pooling within the hood mechanism), difficulty-performing treatments in the retroflexed position in the fundus of the stomach.
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