Clip-with-line traction suture method with adaptation of the mucosal flap in a large transmural defect after submucosal tunneling endoscopic resection of a submucosal tumor at the esophagogastric junction.

Submucosal tunneling endoscopic resection (STER) [1] is a demanding technique that can potentially lead to serious complications [2] [3]. A 51-year-old patient with solid food dysphagia underwent an esophagogastroduodenoscopy, which showed a subepithelial mass just below the esophagogastric junction (EGJ). Endoscopic ultrasound confirmed a well-demarcated 30 × 24 mm subepithelial mass attached to the muscularis propria, predominantly hypoechogenic but with some hyperechogenic foci.