Research progress in laparoscopic endoscopic cooperative surgery for early gastric cancer: A narrative review

Figure 4 Combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique operation steps. A: Placement of several 3-0 black silk sutures laparoscopically to fix the full thickness of the gastric wall, followed by dissection of the seromuscular layer along the outside of the sutures; B: The silk thread is pulled to create a natural “sealing area” in the tumor tissue; C: The mucosal tissue and free seromuscular layer are managed using a mechanical stapler; D: Complete removal of the tumor tissue through the abdominal cavity.