Endoscopic verification of adequate positioning of the bumper, which should be snug but not tight against the gastric wall.
The anvil is pulled through the gastric wall after transoral delivery. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2005. Used by permission.)