An acceptable long term survival after conventional gastrectomy with lymph node dissection for early gastric cancer has been achieved in the 20 th century. In the 21st century, the minimalization of therapeutic invasiveness in order to preserve quality of life (QOL) is a major topic in the management of early gastric cancer. After laparoscopic surgery for gastric cancer was introduced in 1991, an enthusiasm to develop laparoscopic procedures has grown steadily. While early phase recovery after surgery has been improved by laparoscopic surgery, preservation of late phase QOL by function preserving surgery is also essential in regard to this, the sentinel node (SN) concept has been a much discussed topic in gastric cancer surgery to approach this aspect. Recently, the validity of the SN concept has been demonstrated by a number of single institutional studies and prospective multi-center trials are presently ongoing. Theoretically various types of function preserving surgery could be applied in cases of early gastric cancer with negative SNs as less invasive surgery to improve long-term QOL. Although we still have to solve several remaining issues, laparoscopic SN navigation surgery would enable us to apply a novel individualized minimally invasive approach, both in terms of degree of incisional access and extent of function preservation.
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