A novel method of synchronous closure for endoscopic full-thickness resection of exophytic gastrointestinal stromal tumors

Fig. 3 A schematic diagram of the process of resecting gastrointestinal stromal tumors using the synchronous closure method under endosco- py. a The submucosal tumor, originating from the muscularis propria, protrudes into the gastric cavity.b The oral side mucosa of the tumor was incised.c Metal clips were used to fix the incised mucosa, thereby restricting the displacement of the tumor.d A metal clip clamp and pull the tumor toward the gastro lumen side with a traction line.e The anal side mucosa was then incised and a perforation occurred in the anal side mucosa.f The perforation was immediately preclosed with a single metal clip.g While traction was applied, the tumor was further dissected.h The dissection of the tumor was performed with synchronous closure.i The tumor was completely resected, and the wound was closed.E970