Abstract
ndoscopic full-thickness resection (EFTR) is a gastric Efull-thickness partial resection. As tumor enucleation surgery, EFTR may be less invasive than laparoscopic partial resection. However, EFTR has many difficult technical challenges, such as visualizing a clear operative field under a collapsed stomach and endoscopic suturing device. Regarding suturing devices, the only commercially available device is the Over-the-Scope Clip (Ovesco Endoscopy GmbH, Tuebingen, Germany), a clip-based suturing device that is easy to use. The recent development of the Overstitch System (Apollo Endosurgery, Austin, TX) enabled full-thickness suturing with a suturing thread. To obtain the operative field, the lifting method or the mechanical counter traction device have been reported; however, it was very difficult to obtain sufficiently the operative field at certain areas of the stomach, such as in the retroflexed view. We report a newly developed countertraction and full-thickness suturing device for the flexible endoscope.
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