Gastrointestinal mesenchymal tumor of the digestive tract is a potentially malignant tumor. The initial manifestation of the lesion is benign, and with the development of the tumor, the lesion will become malignant, and advanced tumor manifestations such as liver metastasis and ascites will appear. Since intrinsic myxoid mesenchymal tumor is located in the outer part of the digestive tract, it is difficult to remove it completely by traditional endoscopic treatment methods, and mostly open-heart and open-abdomen surgery is performed, which is often difficult to find the lesion intraoperatively due to the small size of the disease. Transendoscopic total gastric wall debulking treatment is an emerging conceptual endoscopic treatment technique, which can not only treat early malignant tumors in the GI tract, but also remove tumors in the deeper layers of the gastric wall including the intrinsic muscular layer. Unlike traditional surgery and minimally invasive laparoscopic surgery, this method can achieve complete removal of tumors while being completely scarless. The scarless surgery has been named as one of the top 10 new medical breakthroughs by Time Magazine. Prior to ESD treatment, ultrasound endoscopy is performed to determine the depth of infiltration and the presence of lymph node metastases. The lesion is then removed gradually along the marked boundary, and the defect in the gastric wall is finally closed with a metal clip to restore the continuity of the gastric wall. The treatment is safe and effective because of its high safety. Compared with traditional treatment, this treatment has the advantages of less trauma, high safety, good treatment effect, good patient compliance, low treatment cost, complete excision of early lesions and staging of tumors, etc. It can achieve complete excision of lesions and complete scarless abdomen after surgery. It also solves the problem of difficulty in finding some small mesenchymal tumors in surgery. At present, this technique can be carried out in only a few hospitals in China, and the development of this technique is helpful to maintain the leading status of Shengjing Hospital Endoscopy Center at home and abroad in the diagnosis and treatment of mesenchymal tumors of the digestive tract. The preoperative gastric cavity shows a locally prominent lesion in the gastric wall Ultrasound endoscopy shows that the lesion is a lesion on the outside of the gastric wall. Endoscopic IT knife incised the gastric wall and peeled off the lesion layer by layer Gradually peeled off the lesion from the muscular layer of the gastric wall The lesion was partially detached from the gastric wall The lesion was cut off and removed The lesion was removed with the envelope intact, and the pathology was a low-grade malignant gastrointestinal mesenchymal tumor Endoscopic closure of the wound and restoration of the integrity of the gastric wall