Cutting edge of endoscopic full-thickness resection for gastric tumor

Figure 1 Illustration of the procedure for endoscopic full-thickness resection without laparoscopic assistance. A: A circumferential incision is made to the depth of the muscularis propria around the lesion using endoscopic submucosal dissection (ESD) devices and techniques; B: After intentional perforation, the serosal layer around the lesion is incised using ESD devices; C: The tumor, including the surrounding muscularis propria and serosa, is removed using the snare; D: The gastric wall defect is closed with several metallic clips.