Laparoscopic distal gastrectomy begins with taking down the gastro-colic omentum along the greater curvature. The stomach is elevated with graspers to provide adequate counter-traction. It is elevated while the tissue is divided. An ultrasonic dissecting device is used to carefully divide the tissue providing excellent hemostasis. Note that the liver is elevated with a self-retaining retractor.This starts in the mid portion of the stomach and continues up to the proximal stomach.