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Despite the wide acceptance of laparoscopic surgical techniques, its use for higher staged gastric cancer has been limited. Laparoscopic total gastrectomy poses many complex challenges, in particular the construction of the esophagojejunal anastomosis. This video shows the resection of a large gastric cancer in an otherwise healthy 53 yo male that required total gastrectomy, distal pancreatectomy, splenectomy, and transverse colectomy. Thus multi-organ resection and total gastrectomy, including the construction of an esophagojejunal anastomosis, can safely and efficiently be performed laparoscopically.