Recently, the treatment of gastric cancer is becoming diversified. In Japan, gastrectomy with D2 lymphadenectomy has been recognized as a standard operation and has been performed widely for years. However, instead of D2 conventional gastric resection, various treatments using endoscopic or laparoscopic methods have been developed. Their usefulness and safety have been established, and the rate of detection of early gastric cancer has risen with the progress of medical technology and systems. The treatment suitable for the given stage must be chosen. In our department, we introduced laparoscopic operations and considered their usefulness and indication. Now, laparoscopic gastrectomy is recommended for cases in cStage I A and cStage I B of the guideline proposed by the Japanese Gastric Cancer Society. Future randomized controlled trials consisting of open surgery and laparoscopic gastrectomy are warranted.