Figure 7.

(A) Longitudinal incision at the 2 o’clock position. (B) Dissection plane. (C) Palisade vessels within the submucosal layer at the esophagogastric junction. (D) The distal margin of the tunnel verified using a retroflexion view from within the gastric lumen. (E) The sharp tip of a triangle-tip knife is used to catch circular muscle bundles and then retract and dissect them toward esophageal lumen. (F) Longitudinal muscle is identified at the bottom of myotomy site. (G) Closure with endoscopic clips.