内镜治疗与外科手术均为早期胃癌（EGC）的标准治疗方式。由于胃癌淋巴引流路径复杂且存在跳跃性转移，尤其pT1b期胃癌的淋巴结转移风险显著升高，故提出了腹腔镜与内镜联合手术（LECS），其成为一种兼顾肿瘤学安全性、胃功能保留及生活质量提升的新兴治疗模式。在LECS中，应用前哨淋巴结（SLN）清扫技术精准实施胃周淋巴结清扫，是该术式的关键环节。选择合适的示踪剂并采用标准化注射方式，可较好地实现SLN显影；而采用整块切除SLN引流区的方式，较“拾取法”更符合肿瘤学安全性原则。同时，LECS对术中冰冻切片病理检查提出了更高要求。未来，基于人工智能的淋巴结转移预测模型有望指导更精准的SLN清扫，这也将成为医工交叉领域的重要发展方向。

For early gastric cancer, endoscopic resection and surgery are currently standard treatment options. Due to the complex lymphatic drainage of gastric cancer and the potential for skip metastasis—particularly with a significantly increased risk of lymph node involvement in pT1b tumors—laparoscopic and endoscopic cooperative surgery (LECS) has emerged as a novel approach that ensures oncological safety while preserving gastric function and improving quality of life. In LECS, the application of sentinel lymph node dissection for precise removal of perigastric lymph nodes has become a critical and essential step. Selecting appropriate tracers and using standardized injection techniques effectively enables visualization of sentinel lymph nodes. Moreover, en bloc resection of the sentinel lymph node basin is more oncologically sound than the “pickup” method, although it places higher demands on intraoperative frozen-section pathology. In the future, under the guidance of artificial intelligence-based models predicting lymph node metastasis, more precise sentinel lymph node dissection will likely represent an important direction for interdisciplinary collaboration between medicine and engineering.