LAUSR

Successful closure of large mucosal defects is vital for submucosal tumors originating from the muscularis propria layer after endoscopic submucosal resection. However, it is difficult to close large defects using only metal clips with use of a single-channel endoscope. Although endoscopic pursestring suturing has been identified as an effective method for large defects, it requires a double-channel endoscope, which increases the technical difficulty. In addition, some new traction methods have been reported to help close large defects, but they require special devices and extra help. How to close large defects effectively and easily with a single-channel endoscope is still an issue worth studying. We report a new closure method with metal clips and surgical sutures (Fig. 1). A patient received a diagnosis of a submucosal tumor, approximately 20 mm in size, located at the anterior wall of the gastric body. EUS showed that the lesion originated from the muscularis propria layer. The patient accepted endoscopic submucosal resection for fear of GI stromal tumor. In consideration ofmuscular injury, the defectwas ready