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Recently, the incidence of upper third gastric cancer has increased, and with it the number of endoscopic submucosal dissection (ESD) procedures performed has been increasing. However, if ESD is not indicated or non-curable, surgical treatment may be necessary. In the case of lower third gastric cancer, it is possible to preserve the upper part of the stomach; however, in the case of upper third gastric cancer, total gastrectomy is still the standard treatment option, regardless of the stage. This is due to the complications associated with upper third gastric cancer, such as gastroesophageal reflux after proximal gastrectomy rather than oncologic problems. Recently, the introduction of the double tract reconstruction method after proximal gastrectomy has become one of the surgical treatment methods for upper third early gastric cancer. However, since there has not been a prospective comparative study evaluating its efficacy, the ongoing multicenter prospective randomized controlled trial (KLASS-05) comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy is expected to be important for determining the future of treatment of upper third early gastric cancer.

Many surgeons find it difficult to perform laparoscopies, operations performed inside the abdominal cavity without opening the abdominal wall. These keyhole operations are particularly taxing due to a lack of depth perception and impaired hand-eye coordination. Consequently, the method has been used for relatively simple operations only. A new type of endoscope, the Endo-Periscope developed in Delft and Tokyo, offers an ingenious solution to the problems. It is based on a new operating principle using a three-dimensional parallelogram mechanism, for which a worldwide patent application has been filed. Another patent for the actual implementation of the principle, a new type of spring,has also been filed.

Many surgeons find it difficult to perform laparoscopies, operations performed inside the abdominal cavity without opening the abdominal wall. These keyhole operations are particularly taxing due to a lack of depth perception and impaired hand-eye coordination. Consequently, the method has been used for relatively simple operations only. A new type of endoscope, the Endo-Periscope developed in Delft and Tokyo, offers an ingenious solution to the problems. It is based on a new operating principle using a three-dimensional parallelogram mechanism, for which a worldwide patent application has been filed. Another patent for the actual implementation of the principle, a new type of spring,has also been filed.