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Technique of anterior per-oral endoscopic myotomy. (A) Submucosal injection to raise a mucosal bleb. (B) Submucosal tunneling using a triangular tip knife. (C) Completion of submucosal tunneling. (D) Selective circular myotomy in upper part of submucosal tunnel. (E) Full thickness myotomy in the lower end of tunnel. (F) Closure of mucosal incision with multiple endoclips.
