Abstract: The esophagojejunostomy is a key and difficult point in laparoscopic total gastrectomy (LTG), it mainly uses circular stapler and Endo cutter. The circular stapler includes trans orally inserted anvil (OrVil^TM), purstring instrument, manual anastomosis, anti puncture placement, etc; The Endo cutter includes esophagus jejunum side to side anastomosis and overlap side to side anastomosis. There are their respective advantages and limitations in the various esophagojejunostomy, no standard is recommended. When it comes to security, overlap side to side anastomosis is better for patients with non upper gastric cancer, and OrVil^TM really has a leading edge advantage compared with other anastomoses and may be used for patients with upper gastric cancer who cannot undergo linear anastomosis. The above anastomosis methods need to be proved by the high quality, large sample randomized controlled clinical studies.