The D2 lymphadenectomy within an oncological gastrectomy is the best option between surgical radicality and improvement of patient survival. Even though minimally invasive gastrectomy and D2 lymphadenectomy is very challenging, it should always be considered since patients can profit significantly from minimally invasive surgical techniques compared to open operation. The difficult minimally invasive approach can be handled well if experience, appropriate preparation of the patient, sufficient diagnostic methods (e.g. endoscopy and computed tomography scan) and current scientific findings are included accordingly. While pancreatectomy and splenectomy were performed regularly in the past, today's oncological gastrectomy does not require a removal of the pancreas or the spleen unless there is tumor infiltration or metastasis. In the future, the use of modern techniques like fluorescent tracers (e.g. indocyanine green) to highlight the lymphatic drainage could support the intraoperative navigation and diagnostics of potentially affected lymph nodes outside the typical margins of the D2 lymphadenectomy. Altogether the minimally invasive D2 lymphadenectomy should more often be considered as a therapeutical option, since its long-term oncological outcome is comparable to the outcome of open procedures, whereas the short-term outcome or postoperative course of patients is better after minimally invasive surgery.