Fig. 4

Scheme of the combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET) procedure. A An endoscopic marking around the tumor from within the lumen of the stomach and laparoscopic marking around the tumor on the serosa contributed to the endoscopic confirmation of the resection line. B Laparoscopic seromuscular dissection around the tumor along the resection line. C The tumor was lifted toward the abdominal cavity for obtaining definite margin-free resection. D Full-layer resection of the stomach with a laparoscopic linear stapling device