Lymph node metastasis from perineal tumors including penile cancer, scrotal Paget’s disease, urethral cancer and other malignant tumors usually metastasize to inguinal lymph nodes first. Iliogastric lymph node dissection is the main treatment for lymph node metastasis in the inguinal region. Traditional iliac inguinal lymph node dissection requires an incision about 500px long on each side, and due to the large incision, the blood supply to the skin is easily affected, and many patients suffer from complications such as skin infection and skin necrosis, which significantly prolong the hospital stay and affect the postoperative quality of life. In addition, the huge incision also affects the aesthetics. Recently, domestic and foreign scholars have reported laparoscopic iliac inguinal lymph node dissection, which largely reduces postoperative complications such as skin flap necrosis and achieves the same results as open surgery. Among them, laparoscopic iliac inguinal lymph node dissection has two routes: cascade and retrograde. The retrograde route is from the distal thigh, from the bottom to the top. In contrast, a cascade is in the abdomen and is performed from top to bottom. Most centers currently take a retrograde sweep. However, our center has opted for the prograde approach, which I believe has several advantages: (1) Prograde laparoscopic ilioinguinal lymph node dissection requires fewer operative holes; if only prograde inguinal lymph node dissection is performed, 3 holes are sufficient, and if additional pelvic lymph node dissection is required, 4 or 5 holes can be added at any time, but overall it is more minimally invasive than the retrograde 6 holes. (2) Parallel dissection may be accompanied by an expanded dissection to the peri-iliac vascular lymph nodes. When inguinal lymph node clearance is found to be positive and peri-iliac vessel lymph node clearance is required, the paralleling clearance can continue with peri-iliac vessel lymph node clearance as long as Trocar is punctured towards the abdomen, whereas retrograde clearance requires reperforation. Therefore, based on the above two points, we believe that paralleling laparoscopic ilioinguinal lymph node dissection is operationally superior to retrograde laparoscopic ilioinguinal lymph node dissection. In our current cases, the results are good, with no complications such as flap necrosis or lymphatic leakage, and it is a better surgical method for treating lymph node metastasis from perineural tumors.