 More than 20 years after the introduction of laparoscopic gastrectomy, many large-scale randomized controlled trials have been conducted in Japan JCOG0912 and JLSSG0901, Korea KLASS01 and KLASS02, and China CLASS01. These trials are all designed to evaluate the non-inferiority of laparoscopic-assisted distal gastrectomy LADG to its open counterpart. No RCT for laparoscopic total gastrectomy LTG exists at this moment. The standardization of techniques for esophagojejunal anastomosis in LTG has been difficult even for experienced surgeons. 