A 69-year-old female was admitted to the hospital mainly because of "distension and pain in the upper abdomen for more than 6 months". Ultrasound gastroscopy showed bulging lesions of the gastric antrum mucosa and incomplete pyloric obstruction (Figure 1）； Pathological diagnosis by biopsy: adenocarcinoma of the gastric antrum mucosa. Preoperative CT imaging staging: T3N1M0. Two-port fluorescent laparoscopic tracer-navigated distal radical gastrectomy and Billroth II + Braun anastomosis were performed under general anesthesia. Intraoperatively, the colored lymph ducts and lymph nodes in the perigastric lymphatic drainage area were observed in fluorescence mode, and dissected clockwise along the subpyloric area, suprapyloric area, suprapancreatic area, small curvature side and large curvature side colored with the tracer indocyanine green (Figure 3，Figure 4，Figure 5）。 After D2 lymph node dissection, the specimen was removed, and the surgical field was visually inspected in black and white light mode for missing colored lymphoadipose tissue, and the specimen was visually inspected to determine whether the resection margin was qualified. The results of pathological examination showed: moderately-poorly differentiated adenocarcinoma with bulge of anterior wall of gastric antrum; Postoperative pathological stage: T3N3aM0.
