Objective: To investigate the feasibility and surgical approach of hand-assisted laparoscopic D2 radical operation for gastric cancer. Methods: The clinical data of 30 patients with gastric cancer admitted to our center from December 2010 to May 2011, who underwent hand-assisted laparoscopic D2 radical gastrectomy by self-designed surgical approach, were retrospectively analyzed. Results: Hand-assisted laparoscopic D2 radical gastrectomy was successfully performed in 29 patients, of whom, radical total gastrectomy was performed in 15 cases, proximal subtotal gastrectomy in 3 cases and distal subtotal gastrectomy in 11 cases. The whole time of surgery was 150–210 (average of 177) min, the surgical incision length was 6–7 (average of 6.86) cm, and the intraoperative blood loss was 80–600 (average of 228) mL. The number of involved lymph nodes detected by postoperative pathology was 11–35 (average of 16.79), and no residual tumor was noted in the surgical margin of any of the 29 cases. The TNM classification of the tumors were one case of stage I, 2 cases of stage II, 8 cases of stage IIIA, 6 cases of stage IIIB and 12 cases of stage IV, respectively. Gastric atony occurred in one case after surgery. One patient was converted to open surgery due to massive intraoperative bleeding. Conclusion: Our properly designed appoach of hand-assisted laparoscopic operation can meet the operating criterion of D2 radical gastrectomy. It is safe and feasible, and may probably become a new procedure of gastric cancer surgery.