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Background:The application of minimally invasive techniques for gastric malignancy is in evolution. In Asia, laparoscopic assisted gastric resection is commonly performed with open reconstruction of intestinal continuity. In the United States, minimally invasive bariatric surgical techniques have been adapted to enable gastric resection with intracorporeal reconstruction. The aim of this study is to access the short term outcomes of minimally invasive gastectromy and reconstruction for gastric malignancy at a single institution.Method:Between November 2004 and October 2010, 68 patients with gastric malignancies underwent MIG. Short term clinical and histopathologic results were analyzed.Results:A total of 68 minimally invasive gastric resections were performed on 31 men and 37 women with median age of 69 years (range 35-96). There were no conversions to open resection. Indications for the procedures were gastric adenocarcinoma (56), gastrointestinal stromal tumor (GIST) (7), high grade dysplasia (3), carcinoid (1) and rabdomyosarcoma (1). There were 17 total gastrectomies, 40 distal, 5 proximal, and 6 wedge gastrectomies. Among patients with gastric adenocarcinoma, 40 underwent a D2 lymphadenectomy and 14 underwent a D1 lymphadenectomy. The median lymph node count was 27.5 (range 8 - 71) for D2 lymphadenectomy and 20.5 (range 8 - 29) for D1 lymphadenectomy. All patients were resected with negative margins. The median operating time was 385 minutes (range 76 - 579 minutes). Median estimated blood loss was 200 mL (range 10-1000mL). Median length of stay for total gastrectomy was 7 days (range 5 - 19) and 6 days (range 1 - 39) for partial gastrectomy. There was one perioperative mortality (1.5%), eight major (11.8%) and 12 minor (17.7%) complications. With a median follow-up of 12.5 months (range 0.2 - 70.5), 82.4% of patients are alive with no evidence of disease.Conclusions:Minimally invasive gastrectomy provides an oncologically sound alternative to open gastrectomy and can be performed with a low mortality rate and an acceptable overall morbidity rate.