In the past, endoscopic submucosal dissection (ESD) was always out of reach for tumors with deeper origin in the digestive tract, and the only way to remove the lesions was through surgery. Professor Liu Bingrong, Director of the Department of Gastroenterology of the Second Hospital of Harbin Medical University, boldly improved and innovated the ESD procedure, and established the “endoscopic intrinsic muscle dissection” for the first time at home and abroad, and accumulated more than 20 successful cases in clinical practice. At the 18th European Digestive Disease Week Congress held recently in Barcelona, Spain, which was attended by 14,059 gastroenterologists from 124 countries, Prof. Liu, as the only invited expert from mainland China, introduced his clinical experience and showed a video of endoscopic surgery to the participants, which attracted wide attention and praise from international colleagues. It is understood that endoscopic intrinsic muscle dissection (EMD) is a brand new concept firstly proposed by Prof. Liu Bingrong on the basis of endoscopic submucosal dissection (ESD), which was firstly applied in the world by Japanese gastrointestinal endoscopists at the end of 1990s, and this technique can completely remove submucosal tumors of the digestive tract with a diameter greater than 2 cm at one time and provide a complete specimen after surgery, which is beneficial for pathologists to evaluate whether the lesion is completely removed (extensive). This technique can provide a complete specimen after surgery, which is useful for pathologists to analyze whether the lesion is completely removed (width and depth) and whether there is metastasis in local lymph nodes or vasculature. Moreover, compared with other minimally invasive endoscopic treatments, ESD has obvious advantages in reducing the local residual rate and postoperative recurrence rate of tumors. However, ESD is difficult to perform and the depth of resection is limited to the whole mucosa and most of the superficial layers of the gastrointestinal wall such as the submucosa. For tumors of deeper origin (originating from the intrinsic muscular layer), this method is very difficult, and the lesion is often accompanied by perforation of the gastrointestinal tract, which is why many people are discouraged by it. Generally speaking, the wall of the GI tract is divided into four layers, including mucosa, submucosa, muscular layer and plasma layer, from the inside out. Inspired by ESD procedure, Prof. Bing-Rong Liu has been focusing on the endoscopic treatment of early-stage cancer and submucosal tumor in the GI tract as the main direction of his discipline, and has been exploring in this field, pioneering the new concept of endoscopic intrinsic muscle layer dissection (EMD) and applying it successfully in clinical practice. It makes it possible to remove submucosal tumors of the GI tract originating from the intrinsic muscular layer. At the same time, this technique has changed the situation of passive treatment of GI perforation in the process of endoscopic treatment, and Prof. Liu’s group first takes measures to deal with possible perforation by disinfection of the gastrointestinal wall and aseptic operation before EMD. Even if a perforation of the digestive tract occurs, in the majority of cases, the “hole” can be closed in a timely manner by means of endoscopic titanium clip closure to reduce the leakage of digestive fluid, and postoperative complications such as peritonitis can be avoided completely. The proposal and development of endoscopic intrinsic base dissection has saved more and more patients with gastrointestinal tumors from the pain of surgery, which has the advantages of no scarring, less trauma, less pain and faster postoperative recovery than traditional surgery, especially it can eradicate tumors while preserving the structure and function of the gastrointestinal tract intact. In recent years, Professor Liu and his colleagues have actively carried out the treatment of both ESD and EMD techniques and successfully cured more than 200 cases of such patients. In July this year, Director Bing-Rong Liu performed ESD surgery on an elderly woman with a huge mucosal layer lesion of the gastric sinus and successfully removed a lesion 10×10 cm in size. In November this year, an 80-year-old male patient with submucosal tumor in the stomach was determined by ultrasound gastroscopy and CT to be huge and deep to the plasma membrane layer. After admission, Prof. Bing-Rong Liu suggested him to undergo surgery to remove the tumor, but the family was unwilling to undergo open surgery considering the patient’s old age. After more than 10 hours of meticulous operation, Director Liu successfully removed the mesenchymal tumor, which had grown out of the outside of the stomach wall and was about 9 cm in diameter, by applying the EMD method with his excellent endoscopic technique. During the operation, Professor Liu overcame unimaginable difficulties, stopped the fountain-like bleeding, precisely cut the stomach wall to remove the tumor completely, and tightly sutured the 2 cm diameter stomach wall wound, thus saving the patient from surgical pain. The patient recovered quickly after the operation without even the slightest symptom of peritonitis and was discharged from the hospital in a week or so.