High Eckardt score and previous treatment were associated with poor postperoral endoscopic myotomy pain control: A retrospective study

Figure 1 The peroral endoscopic myotomy procedure. A: The mucosal layer was longitudinally cut to form a mucosal opening to expose the stratum submucosa; B: Submucosal injection was performed while the mucosa was separated to form a submucosal tunnel (3-4 cm) to the distal end of the gastroesophageal junction (GEJ); C: The myometrial incision was performed from the distal end of the mucosal tunnel opening at 2 cm to at least 2 cm to the distal end of the GEJ; D: After proper hemostasis, the mucosal opening was closed with a hemostatic clip.