Dr. Shan Yuqiang successfully performed the first complete laparoscopic radical total gastrectomy + ORVIL anastomosis in our hospital Recently, a new development in minimally invasive surgery was achieved in our gastroenterology and anorectal surgery, and in close cooperation with the anesthesiology department and the operating room, Dr. Shan Yuqiang, deputy chief physician, successfully performed a complete laparoscopic radical total gastrectomy + ORVIL anastomosis of the esophagogastrojejunum for a patient with cardia carcinoma of the fundus. In other words, after laparoscopic total gastrectomy and standard lymph node dissection, reconstruction of the GI tract such as esophageal jejunum was also completed laparoscopically. Minimally invasive surgery to treat gastric cancer has become a trend, but completely laparoscopic GI reconstruction surgery is difficult, requires multiple instruments and is more expensive, so it is rarely performed at present, and only a few large tertiary hospitals in the province can perform such surgery. However, it is the higher pursuit of laparoscopic technology to achieve the minimally invasive effect as much as possible on the basis of radical tumor treatment. As a true laparoscopic gastrectomy pursued by surgeons, complete laparoscopic GI reconstruction has the advantages of better surgical field, smaller incision (only need to meet the ability to remove the radical specimen), less trauma, and faster recovery, and its advantages are very obvious. There are two main types of completely laparoscopic esophagojejunal anastomosis: 1) end-to-end esophagojejunal anastomosis with a circular anastomosis 2) lateral esophagojejunal anastomosis with a linear cutting anastomosis. We use a new transoral staple holder placement device (OrVilTM) to perform round clutch esophageal jejunal end-lateral anastomosis, which overcomes the difficulty of laparoscopic esophageal purse-string suture placement of round clutch staple holder, effectively reduces the difficulty of anastomosis, and can cut the esophagus first according to the location of the tumor, which has higher surgical margin and is superior to the lateral esophageal jejunal anastomosis. Specific method: The lower end of the esophagus is cut and closed by laparoscopic cutting and closing device according to the requirements of the tumor margin; the front end of the staple holder (mushroom head of the anastomosis) is guided by the nasogastric tube and the mushroom head of the anastomosis is placed on the broken end of the esophagus through the oral cavity; a small incision is made in the abdomen and a tubular anastomosis is placed under sealed pneumoperitoneal conditions to complete the end-lateral anastomosis of the esophagojejunum.