Prediction, prevention and management of gastroesophageal reflux after per-oral endoscopic myotomy: An update

Figure 3 Natural orifice transluminal endoscopic surgery fundoplication. A: Dissection of sub-serosal fibrofatty tissue to reach the peritoneal membrane; B: Creation of opening in the peritoneal membrane; C: Application of loop and endoclips along the serosal aspect of anterior wall of stomach; D: Application of second series of clips along the distal end of myotomy; E: Tightening of the endoloop; F: Endoscopic confirmation of the fundoplication wrap.