The advantages and disadvantages of each technique are different. For most precancerous lesions, EMR is relatively simple, uses few devices, and has a long track record of success. Among its disadvantages, this procedure may require additional surgery for some patients. They may have been cured if treated with ESD, however. Moreover, EMR has a high recurrence rate of 15% to 20%, which necessitates further treatment. ESD has the main advantage of allowing complete dissection of any type of lesion, regardless of the size. It is a basic oncologic principle to remove the entire lesion in one piece, which offers the advantages of accurate histological assessment and staging, curative resection, and a low recurrence rate. The procedure, however, is technically more challenging than EMR and requires advanced endoscopy skills. Additionally, ESD is a relatively complex procedure associated with a higher perforation rate than EMR. It is fortunate that most perforations caused by an ESD can be treated successfully by endoscopy without undergoing surgery. Endoscopic mucosal procedures are available at Advanced Gastroenterology. We serve patients from Orlando FL, Kissimmee FL, St. Cloud FL, Meadow Woods FL, Celebration FL, Williamsburg FL, Buenaventura Lakes FL, and Hunters Creek FL.