An injection-based endoscopic submucosal resection (EMR) was first studied in 1955 using in-vitro models in the human sigmoid colon. It was demonstrated that injecting saline to create a submucosal wheal had a protective effect from the complications of thermal cautery. The first live endoscopic mucosal resection with submucosal injection using a loop diathermy was described in 1973 by Deyhle et al., who reported seven resections of sessile polyps from the colon without any complications. This method was then later pioneered by Soetikno in Japan for the management of early gastric cancer in 1974. Since that time, endoscopic submucosal resection utilization has expanded to Barrett’s esophagus (BE), esophageal dysplasia, and early esophageal cancer.