Fig. 4.
Stapler-assisted mucosectomy: With the aid of three transabdominal-transgastric trocars, a purse-string suture is placed in the distal esophagus without (A) or with the retractor (B). The anvil of a circular stapler is introduced into the distal esophagus and the purse-string suture is knotted (C). After firing of the stapler a circular mucosectomy specimen is obtained while staples approximate the mucosa borders (D).