Fig. 2.
The pocket-creation method with an ST hood is performed as follows. a The duodenal side of the tumor is incised without submucosal dissection. b The gastric side is minimally incised and then dissected to make a pocket. c At the pyloric ring, stable and well-visualized submucosal dissection is enabled by compressing the pyloric sphincter using both traction and counter-traction (red arrows). The tip of the endoscope is effectively held by the pocket (blue arrow). d A tunnel is created from the gastric to the duodenal sides in an antegrade manner.