Although surgery can cure the lesion, it is more traumatic and affects the quality of life of patients. In recent years, the rapid development of minimally invasive gastrointestinal endoscopic treatment technology has enabled us to completely remove early cancer or precancerous lesions under endoscopy with minimal trauma, achieving the same therapeutic effect as that of open surgery, with almost no impact on patients’ quality of life. This is one of the “star” techniques of gastrointestinal endoscopic treatment in recent years: endoscopic submucosal dissection (ESD). It refers to the gradual removal of early cancer lesions from the normal submucosa under the endoscope through a special knife to achieve complete removal of the lesions. Its greatest advantage is that it can completely remove larger lesion tissues at one time and provide complete pathological diagnostic information. It is currently considered as one of the preferred treatments for precancerous lesions and part of early cancers of the GI tract. ESD technique is mainly applicable to those who have early cancer or precancerous lesions in the GI tract, which are limited to the mucosal layer or only superficial submucosal layer (not more than the upper 1/3 of the submucosal layer) invasion, while there are no local lymph nodes and distant metastases. Therefore, a complete and detailed preoperative evaluation and postoperative pathological diagnosis are essential. Since the introduction of ESD technology in 2009, our department has resected lesions in the esophagus, stomach, duodenal bulb and large intestine, striving to serve every patient with excellent technology.