The development of minimally invasive surgery following the first cholecystectomy performed nearly 20 years ago has favored the performance of increasingly aggressive procedures to reduce surgical trauma and improve quality of life during the postoperative period of time (1,2). The management of gastric cancer could not escape this trend, and various minimally invasive technical options have been currently described-early-stage endoscopic mucosal resection, partial resection with limited lymphadenectomy, and in recent years laparoscopy-assisted or fully laparoscopic partial or total gastric resection (3-11). However, no definite evidence is yet available on both their short-term and long-term clinical advantages as compared to open surgery, but we are obtaining increasingly more information in support of the potential benefits of such an approach (2), particularly that these procedures are oncologically appropriate-as suggested in the study by Ibáñez et al. (10)-both from a technical perspective and considering their long-term effects. The two main goals of gastric cancer management are prolonged survival and improved quality of life (12). It is widely accepted that surgical treatment is crucial in the therapeutic approach to gastric cancer, albeit no universal consensus has been reached regarding the specific procedure. This stems from the fact that surgery outcomes are better in Asia than in the West, where Asian-like results could not be reproduced. This has resulted in serious controversy, and some Western authors wonder whether these are distinct conditions with differing behaviours, whether patients are of a different type, and-from a surgical standpoint-which lymphadenectomy is oncologically most appropriate or which gastrointestinal reconstruction should be performed (13). Disease is probably the same in both the East and West, but Asian series indeed report patients with earlier stages and fewer comorbidities, whereas in Europe or the U.S. gastric cancer is diagnosed in more advanced stages, which confers a poorer prognosis (12). From a technical point of view there is no consensus regarding lymphadenectomy extent. While Asian teams support more extensive lymphadenectomies (D2 or D3), most Western groups prefer a more limited D1 dissection entailing a milder postoperative morbidity and lower mortality (12). The reasons for such differences stem from the fact that Japanese groups have reported better outcomes with extensive lymphadenectomy, whereas such results could not be reproduced in Europe or the U.S. (12,13). Thus, randomized studies performed in Europe by Cuschieri and Bonenkamp to compare D1 to D2 lymphadenectomy found that survival was not longer with the D2 approach, while patients treated this latter way did have greater morbidity and mortality (14-16). The possibility of treating gastric cancer laparoscopically adds a new dilemma to those existing: is it possible to reproduce using laparoscopy the same technique as Laparoscopic management of gastric cancer