Simultaneously, our group reported the first laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer.6 Since that time a number of small series advocating laparoscopy-assisted total gastrectomy for gastric cancer have appeared in the literature.7,8 In addition, a multicenter study including 1294 patients with early gastric cancer indicated that laparoscopy-assisted gastrectomy wi