Laparoscopic surgery for gastric cancer in patients with high body mass index

Laparoscopic gastrectomy has gained much popularity in the treatment of gastric cancer in China. But it is more difficult to perform than open gastrectomy. In recent years, the prevalence of obesity is rapidly increasing and the application of laparoscopic surgery for these patients still exists controversial. The major obstacle of its application is mainly associated with its higher risk of complication, technical difficulties, longer operative time and higher conversion rates. The surgical difficulties mainly come from the accumulated visceral fat tissue that may induce bleeding, increase the difficulty of lymph nodes dissection and prolong the operative time. However, with the development of laparoscopic techniques and the increasing experience of surgeons, many skilled surgeons could perform the surgery well and accumulate some experience. The safety and feasibility of laparoscopic surgery for obese patients become acceptable to more and more surgeons. Considering of the surgical difficulties, mastering the surgical skills of laparoscopic surgery of obese patients is critical for performing the surgery successfully. Thus, in our present study, we will introduce some experience to overcome these surgical difficulties and shorten the learning curve.