Gastric cancer is one of the leading causes of cancer-related mortality worldwide. Endoscopic submucosal dissection (ESD), when indicated based on tumor size, stage, and histological characteristics, is a highly successful curative, minimally invasive, non-surgical endoscopic treatment option. However, the risk of adverse events is higher compared to traditional methods. Here, we present a case of ESD in an early-stage gastric carcinoma and endoscopic closure using a new hand-suturing system.