Sentinel lymph node (SLN) is known as the first possible site of metastasis along the route of lymphatic drainage from the primary cancerous lesion [1]. SLN mapping has been a focus of attention in management of various solid tumors to establish individualized minimally invasive surgery. In the fields of breast cancer and melanoma, several multicentric prospective randomized control trials for SLN biopsy are ongoing, and less invasive modified surgical approaches based on the SLN status have already been put into practice. However, the application of the SLN concept for gastrointestinal (GI) malignancies was not recognized until late 1990s because of high incidence of so-called skip metastasis. From the reports in recent years, we found that socalled skip metastases in GI cancers are attributed to the aberrant lymphatic drainage from the GI tract and the most of so-called skip metastases occurred in SLNs [2, 3]. Despite the multidirectional and complicated lymphatic flow from gastric mucosa, the anatomical situation of the stomach is better suited for SLN mapping than that of organs that are embedded in closed spaces, such as the esophagus and rectum. In particular, clinically T1N0 gastric cancer seems to be a good entity for which to try to modify the therapeutic approach. Several studies supporting the validity of the SLN concept for gastric cancers have been reported in the past 5 years in settings of open surgery [4,5,6]. Two major largescale clinical trials of SLN mapping for gastric cancer in open surgery have been started in Japan. The next important issue in this field is the introduction of laparoscopic SLN mapping for early gastric cancer, to establish novel minimally invasive surgery. Laparoscopic modified surgery based on SLN status would be the goal of a minimally invasive approach for pathologically nodenegative early gastric cancer. In this issue of World Journal of Surgery, Tonouchi and colleagues present a result of laparoscopic lymphatic mapping and SLN biopsy for early gastric cancer. It is reasonable to employ the dual-tracer method with blue dye and radioactive tracer for detection of SLNs in this study. Although there are several favorable reports of dye-guided SLN mapping for gastric cancer in open surgery, laparoscopic dye-guided SLN detection for gastric cancer is not feasible. Fast transit of blue dye (5–15 min for diffusion) is a restriction of dye-guided laparoscopic detection of multidirectional SLNs of gastric cancer. Technical errors using the single mapping agent approach are reduced by adding a different approach for lymphatic mapping. The radio-guided method allows us to confirm the complete harvest of SLNs with multidirectional and widespread distribution by gamma probing while the dye procedure enables us to perform real-time observation of the visualized lymphatic vessels. Therefore, we recommend a combination of dye and radioguided methods for systematic lymphatic mapping of gastric cancer as an optimal procedure at this moment. In the present study, the authors reported the case of a false negative study that resulted from a detection error [7]. Although the SLN concept was valid (the metastatic node was radioactive) in this case, the radioactive SLN was missed by laparoscopic gamma probing due to the shine-through effect. As shown in the article by Tonouchi, we have to pay attention to the remaining issues in laparoscopic application of this technology. Laparoscopic gamma probing is still under development, and there are several technical and material limitations. Available rigid-type laparoscopic gamma probes are fixed by entry-trocar, and the freedom to search for SLN and to avoid the shine-through effect from the injection site is seriously restricted. As we have seen several breakthroughs in the field of endoscopic surgery, development of new devices may provide a new frontier of this technology. Limitation of the sensitivity of intraoperative histological examination is another serious problem that can lead to false-negative studyies [8]. After overcoming these remaining issues, laparoscopic SLN mapping for early gastric cancer could be the leading model of individualized minimally invasive approaches for study of visceral solid tumors.