Gastric cancer is an important cause of morbidity and mortality worldwide. Laparoscopic procedures have been adopted to perform oncologic resection but still required a mini-laparotomy incision for specimen extraction. Natural orifice specimen extraction has proven to be an effective method to minimize trauma, decrease complications, speed recovery, and improve cosmetic result.

This is the case of a 67-year-old obese lady presenting with asymptomatic microcytic anemia wherein investigations revealed her to have subcardial gastric adenocarcinoma stage IIA. She underwent neoadjuvant chemotherapy followed by laparoscopic total gastrectomy with D2 lymphadenectomy. The procedure was complemented by a roux-en-y gastrojejunal anastomosis complemented with transvaginal specimen extraction through a posterior colpotomy. The recovery period post-operatively went smoothly and the patient had no major complaints on follow up.

Extracting a gastric cancer specimen transvaginally after laparoscopic procedures is feasible in females, mostly postmenopausal, who are overweight, even obese, and might pose a way to lessen complications post-operatively.