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Advanced laparoscopic surgeries have been widely practiced with an advent of sophisticated instrumentation and development of new technologies. Selection of laparoscopic therapeutic modalities such as intragastric mucosal resection, local resection, and gastrectomy with lymphadenectomy have been decided by gastric cancer treatment guidelines which will be published in the near future in Korea. The indication of laparoscopic surgery is mainly based on the size of lesion, depth of tumor, and histological type. However in order to extend the indications of laparoscopic surgery for gastric cancer, standardization of the procedure of laparoscopic en－block lymphadenectomy is necessary. For more active adoption of Minimally Invasive Surgery in the field of gastric diseases, it is mandatory to resolve medical insurance obstacle and to verify the advantages of this surgery without harming the basic principles of cancer surgery through prospective randomized studies. It is speculated that the ´tailored therapy´ with less invasive laparoscopic surgery for stage I, II and more agressive conventional open surgery for stage III, IV will be the surgical treatment trend for gastric cancer in the near future.
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