. 2010; 25: 1747–1753.Endoscopic mucosal resection (EMR) is now firmly established asa treatment approach for gastric neoplasms, particularly earlygastric cancer (EGC). It is an organ-saving method that is lessinvasive than surgical resection. Moreover, it can provide a concisepathological diagnosis that allows prognosis to be predicted. Withthe aid of instrumental developments, such as an electrosurgicalknife, a more precise endoscope, and high-frequency electrosur-gical current generator, endoscopic submucosal dissection (ESD)enables dissection of deeper tissue layers. Further, ESD has beenreported to be superior to EMR for en bloc resection and localrecurrence rates.