Fig. 1

Endoscopic full-thickness resection (EFTR) procedure for an adenoma in the descending part of the duodenum. a Identification of the duodenal lesion. b Incomplete lifting sign. c The clip was placed on the endoscope and introduced to catch the lesion. d The clip was deployed, creating a pseudopolyp of the lesion above the closed clip. Hereafter, the target lesion was resected en bloc above the clip using an electrosurgical snare. e Resection defect. f En bloc resected specimen