case_images: PMC11744588_01
case_images: Endoscopic resection of a large gastric leiomyoma using the suture-combined tissue clamp traction technique. (a) White light endoscopy shows a long strip-like raised mass on the posterior wall of the upper stomach body, measuring approximately 7 cm in length. (b) Ultrasound endoscopy reveals hypoechoic changes in the lesion, originating from the muscularis propria. (c) A mucosal incision knife (Woodpecker Knife, 2.0 mm) is used to cut the surface mucosa of the mass, exposing the tumor body, which is then peeled off along its edges. (d) Suture traction is used during the operation. (e) The mass is completely excised. (f) The wound surface is sutured with one three-arm clip and multiple tissue clips and (g) postoperative specimen.
case_images: 10.1177_03000605241311122-fig1.jpg
case_images: PMC11744588_01_10.1177_03000605241311122-fig1.jpg
case_images: fig1-03000605241311122
case_images: No marking was performed because of the distinct visibility of the mass, and submucosal injection was administered prior to mucosal incision (Figure 1(a)). Ultrasound endoscopy showed that the lesion appeared as hypoechoic changes originating from the muscularis propria (Figure 1(b)). A mucosal incision knife (2.0 mm with IT-NANO functionality) was used to incise the surface mucosa of the mass, exposing the tumor body, which was then dissected along its edges (Figure 1(c)). During the operation, suture traction was applied (Figure 1(d)), and the mass was carefully excised while maintaining tension on the leiomyoma to avoid inadvertent traction on the muscular layer, thus preventing perforation (Figure 1(e)). The wound surface was closed with one three-arm clip and multiple tissue clips (Figure 1(f)), and the postoperative specimen is shown in Figure 1(g).