Figure 1.

G-POEM procedure: (a) endoscopic view of the narrow pylorus; (b) injection and submucosal incision made 3 to 4 cm from the pylorus in the greater curvature of the antrum; (c) tunnel creation to approximately 2 cm passing over the pylorus; (d)-(e) myotomy of the pyloric and antral muscular layers; (f) endoscopic view of the pylorus after G-POEM; (g) mucosal entry closure by metal clips; (h) mucosal entry scar after 3 months of healing; and (i) endoscopic view of the pylorus after 3 months.