Gastric cancer is one of the most common malignant tumors in the world. Laparoscopic radical gastrectomy has become the main method of gastric cancer surgery. Laparoscopic radical gastrectomy for gastric cancer has undergone the development process from laparoscopic-assisted radical gastrectomy to complete laparoscopic radical gastrectomy, which further reduces the surgical trauma and speeds up the recovery. At present, laparoscopic gastrectomy for gastric cancer has reached the same level of D2 lymph node dissection as open surgery, and the reconstruction of digestive tract can also be completed under laparoscopy. Further promoting minimally invasive gastric cancer surgery is the current focus of attention. As a new minimally invasive surgical method, natural orifice specimen extraction surgery (NOSES) has the advantages of minimally invasive, good operability and feasibility, and has been gradually applied to patients with gastric and colorectal tumors. This operation is the clinical application of NOSES in radical total gastrectomy.