Common postoperative complications of gastric cancer include gastroparesis, incisional infection, bleeding (intraoperative bleeding, postoperative GI reconstruction or postoperative trauma bleeding), anastomotic fistula, and anastomotic stricture. These can occur in both open and laparoscopic surgery. However, laparoscopic surgery is less likely to have complications than open surgery. Complications associated with laparoscopy are subcutaneous emphysema, hypercapnia, and poke hole hernia (hernia where the laparoscopic perforation occurs). Because laparoscopic surgery involves filling the abdominal cavity with carbon dioxide gas to create the surgical space, in older adults with a flabby abdominal wall, carbon dioxide may leak into the subcutaneous tissue and cause subcutaneous emphysema, but this can usually be absorbed on its own. In addition, carbon dioxide entering the blood may cause hypercapnia, and severe hypercapnia can affect heart function, so the attending surgeon will work closely with the anesthesiologist during surgery to detect the value of carbon dioxide in the blood and adjust the parameters of the whistler in time to ensure the safety of the patient. With the maturity of the technology, these problems are rarely encountered in the clinic. The small incision in laparoscopic surgery reduces the chance of contact between organs and air and hands, so the probability of postoperative adhesions is small and intestinal obstruction is less likely to occur. The probability of injury to surrounding organs during laparoscopic surgery is low. Although the incision of laparoscopic surgery is small, the organs will be observed more clearly and carefully due to the magnification of the laparoscope, so it is not easy to injure the surrounding organs. Is laparoscopic surgery prone to anastomotic fistula? In layman’s terms, an anastomotic fistula is a fracture that occurs during the healing process of a surgically sutured interface. It is an inevitable complication of gastric cancer surgery and colorectal cancer surgery, and its occurrence is mainly related to the blood supply and tension of the anastomosis and the patient’s physical condition, and has little to do with open surgery or laparoscopic surgery. Once an anastomotic fistula occurs, it still has a great impact on the patient, who cannot eat and needs to strengthen intravenous nutrition and take drugs to improve the healing ability of the wound. The vast majority of patients do not require reoperation, and the anastomosis can usually heal on its own. Severe anastomotic fistulas require reoperation if conservative treatment is ineffective. Finally, I would like to emphasize one point: laparoscopic surgery and open surgery are not opposites. Open surgery has a history of several hundred years and has its reasons for existence. The widespread use of laparoscopic surgery in the field of gastrointestinal tract and even in surgery affirms its advantages and efficacy, and there is a growing body of evidence that laparoscopic surgery brings benefits to patients. The prerequisite, of course, is that the surgeon is skilled in the skills and indications of laparoscopy and chooses the most appropriate procedure for the patient’s condition.