Fig. 2. Simplified steps in performing peroral endoscopic myotomy. Mucosal incision is done in mid esophagus after saline indigo carmine instillation into the submucosa. Submucosal tunneling (precedes muscle cutting) till gastroesophageal junction. Muscle cutting at 4 cm below the mucosal incision, mucosal incision is closed with standard endoscopic hemoclips. (A) Indigo carmine instillation into the submucosa. (B) Mucosal incision. (C) Submucosal tunneling till gastroesophageal junction. (D, E) Muscle cutting at 4 cm below the mucosal incision. (F) Mucosal incision closed with endoscopic hemoclips.

Int J Gastrointest Interv 2020;9:62~66 https://doi.org/10.18528/ijgii200009

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