Live ESD of a biopsy-proven, bulky adenocarcinoma in long-segment Barrett's oesophagus. A pocket is driven under the most suspicious zone to look for the muscle retracting sign (MRS) before committing, with dye-guided orientation, a retroflexed distal approach, double-line traction and defect review. Includes discussion of MDT planning, R0 versus oncological cure, and post-ESD stricture prophylaxis.