Abstract: Recent advances in endoscopic technology allow us to perform totally endoscopic myotomy for esophageal achalasia. A submucosal tunnel is first created at the anterior wall of the esophagus down to the gastric cardia. Endoscopic myotomy is carried out in the submucosal tunnel and then completed at the end of the submucosal tunnel. After confirmation of smooth passage of the endoscope through esophago-gastric junction, the mucosal incision is closed using regular hemostatic clips. In 280 consecutive
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