This annual hands-on symposium, which includes seven hours for surgical skills hands-on lab, is designed to introduce the attendees to new and emerging techniques in third space endoscopy/endoscopic intramural surgery within the gastrointestinal tract. This course will feature hot topics in diagnostic and therapeutic interventions in third space endoscopy/endoscopic intramural surgery by Cleveland Clinic world-renowned experts. The seven-hour interactive hands-on skills lab includes POEM, G-POEM (POP), ESD, Z-POEM, tissue closure/apposition and more.