Figure 2.

Abbreviated step-by-step guide to performing a cricopharyngeal bar peroral endoscopic myotomy. (A) The cricopharyngeal bar is isolated using a transparent distal attachment and a submucosal lifting agent is injected. (B) A mucosal incision is made directly over the bar with the Dual J Knife. (C) Submucosal dissection is completed on the esophageal side with the Dual J Knife to create a 4-5-cm tunnel. (D) Endoscopic myotomy is performed with the IT NanoKnife, which has a protective insulated tip. (E) The myotomy is extended a short distance distally. (F) The mucosotomy is closed with through-the-scope endoscopic clips