In Japan, a nationwide survey conducted by the Japan Society of Endoscopic Surgery (JSES) has shown that the number of laparoscopic gastrectomies being performed is gradually increasing [1]. As laparoscopic techniques and instruments have developed, surgeons have performed advanced laparoscopic procedures, including laparoscopy-assisted total gastrectomy (LATG) and laparoscopy-assisted proximal gastrectomy (LAPG), with laparoscopic extended lymph node dissection [2–4]. Thus far, some case–control studies and one Phase II study have demonstrated that LADG with D2 dissection is technically feasible and safe [5–7]. For the use of laparoscopic gastrectomy (LAG) with D2 dissection against advanced gastric cancers, further safe techniques must be developed in the future.