We wanted to evaluate the technical feasibility and safety of totally laparoscopic total gastrectomy (TLTG) for treating early gastric cancer.

The medical records of 11 consecutive patients who underwent TLTG after being diagnosed with early gastric cancer at Incheon St. Mary's Hospital, The Catholic University of Korea from February 2005 to September 2009 were retrospectively reviewed and their clinicopathologic characteristics and the surgical results were investigated.

The mean operation time was 385.6±94.1 minutes, the mean time for creating an intracorporeal anastomosis was 97.5±60.0 minutes and the mean number of the harvested lymph nodes was 46.6±15.4. The mean number of days after operation until starting a liquid diet was the 6.15±7.6th postoperative day and the mean hospital stay after surgery was 14.2±11.9 days. There was no case of open conversion, but there were 2 cases of intraoperative complication and 3 cases of postoperative complication. There was one case of postoperative mortality. The patient suffered from thrombocytopenia of an unknown cause, which was refractory to platelet transfusion, on 4th postoperative day and the patient died of intraabdominal bleeding on the 6th postoperative day.

TLTG was a technically feasible and relatively safe procedure. However, a long time for creating the intracoproeal anastomosis and a long operation time are still problems to be solved.