Outpatient hybrid endoscopic submucosal dissection with SOUTEN for early gastric cancer, followed by endoscopic suturing of the mucosal defect: A case report

Figure 4 Endoscopic suturing process for a mucosal defect after endoscopic submucosal dissection. A: Post-endoscopic submucosal dissection mucosal defect in the posterior wall of the gastric antrum; B: A clip with a string attached to the tip is first attached to the anal aspect of the mucosal defect, and an additional clip is attached to the oral aspect of the mucosal defect while sandwiching the string; C: Bring both ends of the mucosa closer by pulling the string out of the mouth; D: Suturing the mucosal defect completely by attaching additional clips to both sides of the mucosal defect and finally burning off the string with the knife of SOUTEN.