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. 2021 Jul 27;13(7):645–654. doi: 10.4240/wjgs.v13.i7.645

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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/

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Technical illustration of the exposed endoscopic full-thickness resection technique with defect closure by means of endoscopic suturing system. A: Endoscopic view of gastric submucosal lesion; B: Precutting and removal of the mucosal and submucosal layer after submucosal injection, in order to expose the tumor; C: Exposed endoscopic full-thickness resection of the tumor and creation of “active perforation”; D and E: Capnoperitoneum management using percutaneously inserted angiocatheter; F: Transmural defect closure with the OverStitch endoscopic suturing system; G: Final apposition of the tissue margins.