DIRAMS Gastrointestinal Surgery focuses on surgical treatment for gastric cancer and gastrointestinal stromal tumors (GIST), along with core general surgical conditions including hernias. Optimal diagnosis and treatment require a system in which multiple disciplines—gastroenterology, GI surgery, medical oncology, pathology, radiology—jointly discuss and decide care. Our Cancer Center has such a system, with experienced specialists in each field, and a multidisciplinary team that meets to determine the most appropriate treatment for each gastric cancer patient, particularly those with advanced disease. We perform open, laparoscopic, and robotic gastrectomies, selecting the most suitable approach for each case and proceeding with thorough explanation and informed consent.