Schematic drawing showing the consecutive steps of the endoscopic resection-cap procedure of a focal lesion in a Barrett's esophagus

(A and B) A transparent cap is attached to the distal tip of the endoscope and the target lesion is lifted by injection of a fluid, usually diluted epinephrine (1:100.000), into the submucosal layer, using a standard sclerotherapy needle.
(C and D) After removal of the needle, a crescent shaped snare is positioned into a distal ridge within the cap. The lesion is sucked into the cap thus creating a pseudo-polyp that is immediately captured by forcefully closing the pre-positioned EMR-snare.
(E) The lesion is removed using electrocoagulation.