Figure 4.

Endoscopic view of the procedure of ESD using GSF. A: Marks are made at several points along the outline of the lesion with a coagulation current; B: The mucosa is incised outside the marker dots to separate the lesion from the surrounding non-neoplastic mucosa using GSF; C: Completion of the GSF cutting around the lesion with a safe lateral margin; D: The submucosal connective tissue beneath the lesion is grasped and lifted up and excised using GSF from the underlying muscle layer; E: The lesion is cut completely from the muscle layer; F: The resected specimen showing en bloc resection of the lesion.