Figure 6.

(A) The CO₂ insufflator (UCR; Olympus Medical Systems Corporation, Tokyo, Japan) used with a regular insufflating tube (MAJ-1742; Olympus) to maintain CO₂ insufflation during endoscopy. (B) The air/water button of the endoscope should remain closed during peroral endoscopic myotomy. (C) High-frequency electrogenerator (VIO 300D; ERBE Elektromedizin GmbH, Tubingen, Germany). (D) The endoscopic trolley is shown situated at the right side of the intubated patient.

Notes: The patient is in a supine position, with open abdomen and periodically checked during the procedure. Cut and coagulation pedals are fixed on metallic stairs on the right side of the patient.