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Background: Advances in diagnostics have increased the number of detections of early-stage proximal gastric cancer, and laparoscopy-assisted proximal gastrectomy (LAPG) has become prevalent for this cancer, especially in Japan. Although we have performed LAPG with esophagogastrostomy, this reconstruction technique is sometimes complicated with reflux esophagitis. For the purpose of prevention for this complication, the gastric tube reconstruction for proximal gastrectomy was reported by Adachi and colleagues. We applied this procedure to LAPG using the transoral anvil. METHOD: From April 2001 through November 2009, LAPG was performed in 78 patients with early gastric cancer in our institution, 2 of whom could have gastric tube reconstruction using tranasoral anvil (Orvil, Autosuture, Norwalk, CT). The initial trocars was placed at the periumblicus, and four trocars were added at upper abdominal portions. After completing dissection and trasecting the esophagus, the periumblic incision was extended to 3 cm to remove the stomach. After gastric tube was made extracorporeally, the handpiece of EEA stapler was inserted in the gastric tube, and the gastric remnant was returned to the abdmen, then anastomosis was completed intracorporeally. RESULTS: Neither patient complained of heartburn suggesting reflux gastritis. Following endoscopy revealed no reflux esophagitis. In the barium-meal study, regurgitation from the gastric remnant to the esophagus was not shown. CONCLUSION: The gastric tube reconstruction with the transoral anvil could be technically feasible, simple, and safe for reconstruction after LAPG.