Reply to Bureš & Rejchrt

Dear Sir,

We thank Drs Bureš and Rejchrt for their comments on our paper. We agree that optimal positioning of the overtube is not always straightforward and that the overtube tip does not always lie in the ideal position in the duodenum. Their comments on the x-ray images shown in our article are understandable, but we do not believe their interpretation is correct. Interpretation of the x-ray images is somewhat difficult because of the position of the patient. Although the caption states that the patient is in the left lateral position, it can be seen that the patient has rolled forward somewhat, as the spine is not the most lateral point on the image. Nevertheless, the position is mainly lateral, so the loop of the duodenum passes posteriorly from the stomach and then superiorly and anteriorly to the duodenojejunal flexure. Hence, the arrows indicating the tip of the overtube in the proximal duodenum and the duodenojejunal flexure are correct.