Fig. 5.

In vivo animal experiments using pure endoscopic full-thickness resection and full-thickness suturing. (A) An area 40 mm in diameter was marked as a simulated tumor. (B) Using the Mechanical Counter-Traction System, which is housed inside an overtube, the collapsing stomach wall was extended with eight expansion arms, and a 40-mm-diameter virtual tumor was fully resected. (C) After full-thickness resection, single-nodule full-thickness suturing of the 4-mm bite and 4-mm pitch was performed. Three stitches had been done (green arrows). (D) Ten stitches were put in the wound (yellow arrows), and the experimental dog survived without complications for 1 year after surgery.