What is the best reconstruction after totally laparoscopic distal gastrectomy if the delta-shaped gastroduodenostomy cannot be performed?

Totally laparoscopic distal gastrectomy (TLDG) means that all the processes are performed laparoscopically without a mini-laparotomy on the epigastrium for the reconstruction in laparoscopy-assisted distal gastrectomy (LADG) (1). Delta-shaped gastroduodenostomy is a representative type of intracorporeal anastomosis. It has been reported that early postoperative outcomes, such as estimated blood loss, return of bowel function, postoperative pain and hospital stays are significantly improved in TLDG compared with LADG.