Abstract Purpose. To present the technical issues of laparoscopic extended gastrectomy (with the lower third of the esophagus resection and mediastinal lymph node dissection) in patients with «true» gastoesophageal junction cancer (GEJ) — Siewert type II. Discussion. Nowadays, the incidence of GEJ cancer has been increasing compare to gastric cancer patients. The most controversial question is safety and efficiency of laparoscopic procedures of Siewert type II GEJ cancer, because of particular characteristics of these tumors. Primary, location of these tumors are between thoracic and abdominal cavities. Secondly, histology, depends on borderline between squamous and tubular, and due to its origin, the cancer may be either squamous or adenocarcinoma. Thirdly, lymph node metastasis might spread both into abdominal and thoracic lymph nodes. According to Y. Kitagawa (2015) data, if the tumor invade esophagus less than 3 cm, transchiatal approach should be chosen. If the tumor invades esophagus more than 3 cm, two-zones procedure is indicated. Conclusion. In our article we present technical aspects surgical procedure for advanced gastroesophageal junction cancer. The main features are mediastinum lymph node dissection and «high» anastomosis creation in the lower mediastinum.