Balloon-Armed Mechanical Counter Traction and Double-Armed Bar Suturing Systems for Pure Endoscopic Full-Thickness Resection

Endoscopic full-thickness resection (EFTR) is a gastric full-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),1 a clip-based suturing device that is easy to use.