Total laparoscopic distal gastric cancer radical “β”-shaped Bi-II anastomosis technique I. Total laparoscopic gastric cancer surgery has the advantages of small surgical incision, light postoperative pain, fast recovery of postoperative gastrointestinal function and better laparoscopic anastomotic view, especially for patients with larger BMI. In recent years, some experts in Japan reported that linear cutting closures should be used to perform Bi-Ⅰ type anastomosis, i.e. triangular anastomosis or β anastomosis after total laparoscopic distal gastric resection for gastric cancer, but most gastric cancer patients in China are progressive patients, and there are fewer cases of early gastric cancer and more gastric resections, so most of them need to perform Bi-Ⅱ type gastrojejunostomy to reconstruct the digestive tract. At present, when performing a total laparoscopic BII gastrojejunostomy, it is difficult to close the common opening directly with a linear cutter; the narrowing of the outflow or inflow tract is easily caused by the use of hand sutures; the suturing time is long; and the safety is poor. We designed the “β”-shaped Bi-II anastomosis technique for the radical treatment of distal gastric cancer under total laparoscopy, which has the advantages of simple operation, safety and short reconstructive surgery. Because the shape of the anastomosis resembles “β” shape after anastomosis, we initially named it “β”-shaped Bi-II anastomosis. The anastomosis can be placed on the side of the greater curvature or on the posterior wall of the stomach. During the anastomosis, the operator first stands on the left side of the patient to perform the anastomosis between the posterior wall of the residual stomach and the jejunum, then the operator turns to the right side of the patient to place a linear cutter through the common gastrointestinal opening toward the spleen to stimulate the linear cutter for the second time to place the common opening on the anterior wall of the anastomosis, and the third time to stimulate the linear cutter to close the common opening. The distance of the cutting edge from the tumor needs to be noted when dissecting the stomach, and intraoperative gastroscopic positioning is necessary, especially when the tumor lesion is small. The advantages of the β-Bi II anastomosis under total laparoscopy The gastrointestinal common opening is placed in the middle of the anastomosis, and only the anterior wall of the anastomosis needs to be closed when closing the common opening, so it can effectively prevent the narrowing of the outflow or inflow tract caused by closing the common opening directly with the linear cutter closure. The linear cutting closure is easier to operate laparoscopically, the anastomosis is large and less prone to stenosis, and the anastomosis under direct vision can effectively prevent anastomosis-related complications such as anastomotic torsion. The specimen is removed through a small incision in the umbilicus, and a Brownian anastomosis of the outflow and inflow tracts can be easily performed through this incision with a linear cut closure.