{
  "abstract": "Introduction Gastric subepithelial lesions (SELs) from the muscularis propria increasingly require definitive diagnosis and curative resection. Whilst exposed endoscopic full-thickness resection (EFTR) offers a minimally invasive alternative to surgery, conventional free-hand EFTR is technically demanding and time-consuming.Methods Consecutive patients undergoing ‘grasp-pull-cut’ EFTR (GPC-EFTR) for gastric SELs at Singapore General Hospital between February 2024 and August 2025 were prospectively enrolled. All procedures were performed under general anaesthesia using dual-channel gastroscope with CO 2 insufflation and prophylactic antibiotics. A snare was positioned around the lesion base whilst grasping forceps applied sustained traction to elevate and mobilise the SEL. Once adequate tension was achieved, the snare was advanced and closed to ensure full-thickness capture before en bloc resection using blended current. Gastric wall defects were closed with endoscopic suturing or clips.Results Six patients (mean age 55.7 years) underwent GPC-EFTR. Median lesion size was 2.5 cm (1.5–4.0 cm); most (66%) originated from muscularis propria on pre-procedure endoscopic ultrasound. Technical success with en bloc and R0 resection was achieved in all cases. No immediate or delayed adverse events occurred. Median procedure time was 100 minutes (range 60-150 minutes) including closure. Median hospital stay was 2 days. Final histology revealed gastrointestinal stromal tumour (n=3), leiomyoma (n=1), inflammatory myofibroblastic tumour (n=1), and neuroendocrine tumour (n=1).Conclusions The simplified GPC-EFTR technique enabled consistent full-thickness capture and safe en bloc resection of gastric SELs without adverse events. Its straightforward mechanism reduces procedural complexity and may support wider adoption of exposed EFTR for selected lesions.",
  "authors": [
    {
      "affiliations": [
        "Singapore General Hospital, Singapore, Singapore"
      ],
      "name": "Chee H Lim"
    },
    {
      "affiliations": [
        "Singapore General Hospital, Singapore, Singapore"
      ],
      "name": "Ravishankar Asokkumar"
    }
  ],
  "title": "P28 Grasp-pull-cut endoscopic full-thickness resection: a simplified approach for gastric subepithelial lesions",
  "uid": "f53987d6-751f-509a-a9b4-9a207a016581"
}