Renal tumor is one of the common tumors in the urological system, and most of them are malignant. In the past, renal tumors were mostly treated by open surgery, but with the development and maturity of laparoscopic technology, renal tumors are more and more often treated by laparoscopic surgery. Recently, Dr. Wu Xuejie, chief physician of the Minimally Invasive Laparoscopy Center, successfully performed a radical laparoscopic kidney cancer surgery via the retroperitoneal cavity for an elderly and high-risk patient with the great assistance and close cooperation from the Department of Anesthesiology and Surgery, Cardiovascular Medicine, Surgical ICU and other related departments. The patient was 71 years old, suffering from hypertension, old myocardial infarction, cardiac and pulmonary insufficiency, etc. He was found to have a mass in the middle and upper part of the left kidney with a size of nearly 6 cm and rich blood flow signal. The operation was performed only by making 0.5cm, 1.5cm and 1cm incisions in the anterior, middle and posterior axillary lines of the left lumbar region respectively to establish a laparoscopic operation channel, and before freeing the kidney, the renal artery and vein were firstly ligated to prevent the tumor from metastasis due to extrusion; then the kidney together with the renal fat capsule and Then, the kidney, together with the renal fat capsule and the lymphatic tissue of the renal hilum, was completely resected, and the ureter was removed by freeing downward. After the operation, one of the access incisions was enlarged and removed with a special impermeable specimen bag. The postoperative pathology report was clear cell carcinoma of the kidney with no tumor infiltration in the surrounding tissues. The patient was able to move around and eat on the second day after surgery, and the patient recovered well after surgery. Open surgery for kidney cancer usually requires a large incision of about 20 cm, and the surgery requires cutting multiple layers of muscles in the lumbar abdomen, which is more damaging. Laparoscopic radical kidney cancer surgery has many advantages such as small surgical incision, magnified image, clear vision, clear anatomical level, reliable free ligation of blood vessels during surgery, etc.; and free tissue with ultrasonic knife, less bleeding, less damage and less complications. The patient can get out of bed early after surgery, which reduces the occurrence of lung infection and lower limb venous thrombosis; early feeding (via retroperitoneum) makes the patient recover faster. Laparoscopic surgical treatment of kidney cancer can also be performed in various surgical methods such as renal tumor enucleation and partial nephrectomy according to the site, size and invasion range of the tumor, and its long-term surgical results have been shown by a multicenter and large sample study to be comparable to open surgery, but with less damage and faster recovery. (Note: This patient has been followed up for more than 1 year and recovered well after surgery.) Surgical experience: 1. The patient is a 71-year-old patient and suffers from various diseases such as old myocardial infarction, hypertension, cardiopulmonary insufficiency, etc. The surgery is extremely risky, and it is very important to carefully evaluate and carefully prepare the patient before surgery to improve the function of each organ in order to improve the patient’s tolerance of the surgery. 2. For such high-risk patients, careful preparations must be made before surgery in multiple aspects such as anesthesia, surgery and postoperative monitoring, and the strength of related departments must be integrated to improve the safety factor. 3. Patients with large tumors and rich blood supply are prone to hemorrhage, so careful operation is required to reduce intraoperative fluctuations. With lumpectomy, the vision is clearer, the operation is more delicate and the damage is smaller. 4. The surgeon is not a surgical craftsman, but must have a global concept and comprehensive professional knowledge. Surgery is a systematic project, and must have a comprehensive control of various conditions of the patient and prepare carefully in all aspects in order to have and improve the ability to complete the surgery successfully under complicated conditions. Surgeons sometimes need to dance on the tip of the knife.