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GIE Volume 5, No. 6 : 2020 Although an endoclip was placed on the responsible diverticulum, active bleeding persisted. She was then referred to the emergency department of our hospital. Another colonoscopy was urgently performed using a PCF-Q260AZI endoscope (Olympus, Tokyo, Japan). Active and sustained bleeding was visualized from the diverticulum in the sigmoid colon, where the previous clip was placed (Fig. 2). Initially, we decided to proceed with endoscopic band ligation (EBL). The endoscope was withdrawn and reinserted with a ligation device (MD48910B EBL device; Sumitomo, Tokyo, Japan) (Video 1, available online at www.VideoGIE.org). The bleeding diverticulum was reidentified (Fig. 3). We attempted to suction the diverticulum with the ligation device; however, we were unable to sufficiently perform suction owing to the firmness of the diverticulum and could not ligate the diverticulum. During the attempt, the clip was unexpectedly dislodged from the diverticulum, and active bleeding continued (Fig. 4). We decided to use an over-the-scope clip (OTSC; Ovesco Endoscopy, Tübingen, Germany). After the bleeding site was marked with an endoclip, the colonoscope was removed. The OTSC system was attached onto a GIF-