早期胃癌行腹腔镜远端癌根治术的安全性及有效性已经得到临床研究证实。全腹腔镜远端胃癌根治术(TLDG)需要在腔镜下完成消化道重建。完全腹腔镜下消化道重建有着更好的操作视野及操作空间，且消化道重建的过程在腹腔镜直视下完成。全腹腔镜消化道重建对手术者的操作技巧要求更高，在实施TLDG时需要注意以下几点：(1)离断胃时，需要注意远切缘与近切缘距肿瘤边缘的距离，保证手术切缘肿瘤学安全性；(2)在进行消化道重建时，操作需在腹腔镜直视下完成，避免术中误损伤；(3)在进行消化道重建前，需要确定拟吻合的肠道位置以及输入袢、输出袢的蠕动方向，保证吻合口通畅。实践证明，TLDG是安全可行的。

The safety and effectiveness of laparoscopic distal gastrectomy in the treatment of early gastric cancer have been proven by clinical evidence. Total laparoscopic gastric cancer surgery should include intracorporeal anastomosis with better surgical view and space. Comapred with laparoscopic-assisted gastrectomy technique requirements are higher in totally laparoscopic gastrectomy and several key points should be stressed: (1) ensure the oncological safety of resection margin before the anastomosis; (2) the intracorporeal anastomosis must be performed under direct vision to prevent side-injury. (3) the site of anastomotic stoma and the direction of gastrointestinal transmit should be confirmed before the anastomosis. The totally laparoscopic distal gastrectomy is an effective treatment strategy for patients with early gastric cancer.