1. Closure of persistent gastrocutaneous postpercutaneous endoscopic gastrostomy fistula by simple percutaneous suturing with endoscopic assist 
Takako Tasaki, MD, Yoshitatsu Arakaki, MD 
Gastrointestinal Endoscopy 
Volume 76, Issue 3, Pages (September 2012)
DOI: /j.gie
Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

2. Figure 1
A schematic illustration of percutaneous endoscopic suturing of the gastrocutaneous fistula. A, A trocar is passed through the abdominal wall into the gastric lumen next to the fistula. A suture is then inserted into the trocar. B, The gastric end of the suture is externalized by using forceps under endoscopic observation. C, The procedure is repeated to insert a total of 2 sutures in the abdominal wall. D, A surgical knot is made with the 2 sutures outside the fistula. E, The cutaneous ends of the sutures are pulled back and the surgical knot is moved into the stomach through the fistula. F, Another surgical knot is tied outside at the skin level to obliterate the fistula.
Gastrointestinal Endoscopy  , DOI: ( /j.gie )
Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

3. Figure 2
The gastric end of the suture inserted through trocar is externalized by using forceps under endoscopic observation. After this method is repeated, a surgical knot is made with the 2 sutures outside of the abdominal wall.
Gastrointestinal Endoscopy  , DOI: ( /j.gie )
Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions