© 2019 JMLL, Tokyo, Japan. Endoscopic Submucosal Dissection (ESD) has been increasingly accepted as a minimally invasive treatment for the patients with early gastrointestinal cancers. However, reliable ESD technique demands high maneuverability, and the success of the operation is dependent on each operator's skill. We have developed a novel laser endoscopic system for ESD to overcome such technique-related difficulties. Compared to conventional ESD using electrosurgical knives, an ESD method using the CO2 laser offers the advantages of less risk of perforation and the prevention of extensive thermal damage, because the CO2 laser is strongly absorbed by water. Furthermore, due to the non-contact technique associated with the CO2 laser and adequate visualization of the treatment area, the laser system may provide every endoscopist with more precise and safer treatment.