Laparoscopic gastric cancer surgery has obvious minimally invasive advantages over conventional open surgery in the treatment of early gastric cancer, and has comparable near and long-term efficacy to open surgery. However, unlike conventional open surgery, laparoscopic view of gastric cancer surgery lacks easily identifiable anatomical landmarks and overall anatomical orientation, and lacks the exposure of various pulling hooks and sufficient assistant collaboration as in open surgery, so it is impossible to fully expose the entire surgical field as in conventional open surgery. Some of the simpler problems that occur in the case of open surgery, such as vascular injury and bleeding during lymph node dissection, may become difficult points in laparoscopic D2 radical surgery for gastric cancer or even in conversion to open surgery. Therefore, Korean scholar Kim et al. concluded that only after completing 50 cases of laparoscopic gastric cancer surgery could they cross the learning curve and achieve a more optimal lymph node dissection. Once the operator has mastered the skills of laparoscopic gastric cancer surgery, laparoscopic surgery can show its obvious minimally invasive advantages, such as fast recovery of gastrointestinal function, early discharge from bed, short hospital stay, small abdominal wall scar, few complications, and good postoperative quality of life. In China, Yu Peiwu et al. reported 105 cases of microscopic radical gastric cancer treatment for progressive gastric cancer, all of which achieved good surgical results, and its safety and feasibility in technology were confirmed. Our data showed that the intraoperative and postoperative patient observation indexes of the laparoscopic group were significantly less than those of the open group, and the open turn-over rate of laparoscopic gastric cancer surgery was only 9.1%. Therefore, we believe that laparoscopic gastric cancer surgery has the advantages of safety and fast postoperative recovery. Meanwhile, laparoscopic gastric cancer surgery has the feature of low postoperative complication rate. Some scholars believe that the incidence of postoperative complications, especially non-surgical complications, is significantly lower than that of open surgery due to the obvious advantage of minimally invasive laparoscopic gastric cancer surgery, which reduces the impact of the surgery itself on the patient’s organism. Some scholars also believe that although laparoscopic gastric cancer surgery is complicated, the postoperative complication rate is not higher than that of traditional open surgery. Our data showed that the postoperative complication rate in the laparoscopic group was 12%, which was lower than that of patients undergoing open surgery during the same period. Whether laparoscopic lymph node dissection can reach a level comparable to that of open surgery is still a source of doubt and concern for many scholars, although the minimally invasive advantage of laparoscopic surgery is gradually being recognized, the prerequisite for this advantage to be established is that the number of lymph nodes dissected reaches or exceeds that of open surgery. Overseas, Tanimu et al [13] retrospectively analyzed 235 cases of laparoscopic D2 radical surgery for gastric cancer and 200 patients undergoing open surgery and concluded that the average number of lymph nodes cleared in the two groups was 31 and 30, respectively, and the difference was not statistically significant, and laparoscopic gastric cancer surgery could fully achieve the effect of open surgery in terms of lymph node clearance. In contrast, in a retrospective analysis of 59 cases of laparoscopic total gastrectomy and 66 cases of open surgery in China, Du et al. concluded that the average number of lymph nodes cleared in the two groups was 36±13 and 34±16, respectively, and the difference was not statistically significant. Skilled laparoscopic surgical technique and a good sense of anatomical hierarchy in the lumpectomy field are the keys to lymph node dissection; the effective magnification of laparoscopy can show finer structures such as veins, nerves and fascia, which is beneficial to the operator for lymph node dissection in the vascular sheath; moreover, the ultrasonic knife has good cutting and hemostatic effects as well as its effect of light damage to the surrounding tissues, which is more suitable for the nakedness of blood vessels. Our data also showed that the mean number of lymph nodes cleared was 30±8, with a median of 26, which is comparable to the results reported about open and laparoscopic surgery at home and abroad, indicating that laparoscopic surgery clears lymph nodes thoroughly. Therefore, laparoscopic D2 radical resection of distal gastric cancer can be sufficient to achieve the same radical effect as open surgery.