Abstract: Carcinoma of the esophagogastric junction can be radically resected through thorax or abdomen. Because abdominal operation can achieve more ideal abdominal lymph node dissection and less injury of respiratory function, it is ideal for the elderly patients and patients with poor pulmonary function. The classic laparoscopic radical gastrectomy needs a small abdominal incision for making tubular stomach and installation of stapling devices. All the procedures were completed via the main operating trocar. In November of 2011, a 65 year old male patient with poor pulmonary function and carcinoma of the esophagogastric junction underwent modified total laparoscopic esophagogastric anastomosis. During the operation, the thorax esophagus was mobilized about 5 cm above the esophageal hiatus, then it was pulled to the abdominal cavity and transected. After inserting the OrVil via the mouth, the esophagogastric anastomosis was done. The operation went through smoothly and the procedure was completed conveniently and quickly. The patient recovered well after operation with no local recurrence and metastasis.