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Percutaneous endoscopic intragastric surgery (PEIGS) is an exciting minimally invasive surgical approach. The widespread use of this surgical approach awaits introduction of suitable equipment that is safe and user-friendly. It also awaits refinement of the technique and demonstration of feasibility, safety, and efficacy. In this study, we present our improvements on the design of the gastric access cannula and our experiments on PEIGS.Nine experiments on fresh sheep stomachs and 1 living nonsurviving animal experiment were carried out to demonstrate the feasibility and efficacy of PEIGS. Special emphasis has been put on analyzing factors affecting spatial orientation in the animal stomach model and studying endoscope/instrument positions for different gastric areas.PEIGS is a promising minimally invasive approach. Advances in this approach can allow elaborate intragastric surgical interventions. Further improvements in equipment, more animal experiments, and clinical studies are needed to overcome certain problems in the approach.