1, Objective Gastric diversion surgery (GBP) has a definite therapeutic effect on diabetes mellitus. The technical difficulties of laparoscopic gastrointestinal anastomosis limit the development of minimally invasive GBP, and there is a lack of a safe and feasible laparoscopic gastrointestinal anastomosis method in clinical practice. The authors introduce a new technique: laparoscopic gastrojejunal in vivo circular anastomosis using a transoral placement staple anvil (OrVilTM, Covidien, USA). The pneumoperitoneum was established routinely, the greater curvature and the lesser curvature of the stomach were fully freed and then disconnected with a cutting suture, and the staple anvil was placed into the gastric cavity through the oral cavity using the OrVilTM system. A small 4-cm incision was then made in the midline of the abdomen, through which a jejuno-jejunal anastomosis was performed to form a jejunal branch of a certain length, and a circular anastomosis was placed in the jejunum and then introduced into the abdominal cavity to complete the gastrojejunostomy in vivo. OGTT, insulin release test, C-peptide release test, glycated hemoglobin and body mass index were checked before and 1 month after surgery. 3. Results Fifteen patients with type 2 diabetes mellitus underwent successful laparoscopic GBP with no intraoperative complications or intermediate open abdomen. The mean operative time and bleeding volume were 105 min and 110 ml, respectively. postoperative fasting glucose and HbA1c glucose metabolism were significantly improved compared with those before surgery. 4. Conclusion Laparoscopic sub-GBP was successfully completed using transoral placement of the stapled anvil head, and postoperative glucose metabolism was significantly improved in type 2 diabetic patients.