胃肿瘤腹腔镜与内镜联合手术（LECS）通过腹腔镜与消化内镜的协同融合，克服了单一微创技术的局限，能够实现早期胃癌及胃黏膜下肿瘤的精准定位、局部精准切除与胃功能保留，现已成为胃外科微创治疗的重要发展方向。近年来，人工智能辅助识别、术中影像导航、机器人手术系统、荧光成像及新型吻合器械等前沿技术不断融入LECS，推动了胃肿瘤LECS诊疗向智能化、数字化方向演进。这一变革不仅提升了原发病灶切缘判定、淋巴结转移识别及复杂创面重建的精准度与安全性，更借助可穿戴设备将一体化照护延伸至术后远程随访。尽管前景广阔，智能化LECS平台的全面临床转化仍面临诸多挑战。

Laparoscopic-endoscopic cooperative surgery (LECS) for gastric tumors, characterized by the synergistic integration of laparoscopy and digestive endoscopy, successfully overcomes the inherent limitations of standalone minimally invasive techniques. It enables precise lesion localization, targeted local resection, and maximum preservation of gastric function for early gastric cancer (EGC) and gastric submucosal tumors, thereby becoming a pivotal direction in minimally invasive gastric surgery. Recently, the continuous incorporation of cutting-edge technologies, such as artificial intelligence (AI)-assisted recognition, intraoperative image navigation, robotic surgical platforms, fluorescence imaging, and novel stapling/sewing instruments, into the LECS framework has propelled the diagnostic and therapeutic paradigms toward an intelligentized and digitalized era. This transformation not only improves the accuracy and safety of determining resection margins of primary lesions, identifying lymph node metastasis, and reconstructing complex wounds, but also extends integrated care to postoperative remote follow up through wearable devices. Despite its promising prospects, the full clinical translation of intelligent LECS platforms still faces numerous challenges.