Footnotes

• Contributors Study conception and design: AH. Acquisition and interpretation of data: AP, AE, AH, MO. Writing and final approval of the manuscript: all authors.

• Funding Funding was obtained from Cook Medical for the Instinct clips used in the study.

• Competing interests None declared.

• Patient consent Obtained.

• Provenance and peer review Not commissioned; internally peer reviewed.

• Data sharing statement Electronic patient record (EPR), Sunrise, Allscripts.