Endoscopic en bloc resection of an exophytic gastrointestinal stromal tumor with suction excavation technique

Figure 4 Illustration of the endoscopic suction excavation technique. A: After submucosal injection of sodium hyaluronate, a circumferential incision and removal of the overlying mucosa were performed; B, E: Careful muscular dissection between the tumor and serosa with a hook knife; C, F: Endoscopic suction using the end of a cap-fitted endoscope attached to the tumor; D, G: Submucosal injection of sodium hyaluronate; H: Tumor fully extracted after repeated careful dissection and endoscopic suction.