Lymph node metastasis status is the most important factor affecting the survival of patients with penile cancer. Penile cancer is one of the few tumors that are cured by regional lymph node dissection. The concept of radical inguinal lymph node dissection was introduced by Daseler as early as 1946, and the scope of this procedure ensured tumor control, but the associated complication rate was high. 1988 Catalona proposed a modified inguinal lymph node dissection, which reduced the extent of lateral and inferior dissection while preserving the saphenous vein and suture muscle without transposition. The modified procedure reduced the complication rate to a certain extent, but due to the insufficient extent of dissection in patients with positive lymph nodes (increasing the postoperative pathological false negatives), the removal of all regional lymph nodes could not be guaranteed, and there was a possibility of tumor residual, thus affecting the tumor control effect. Several foreign publications have reported regional lymph node recurrence after modified inguinal lymph node dissection, up to 15%. In addition, the Dynamic Lymph Node Imaging Study (2008) has conclusively shown lymphatic drainage in the superior lateral aspect beyond the modified inguinal lymph node dissection. Currently, only the European Association of Urology (EAU) has developed guidelines, the 2010 version of which states that patients with positive preoperative lymph node confirmation (fine needle aspiration biopsy or dynamic biopsy of the anterior lymph nodes) should be treated with radical lymph node dissection coverage. Some European centers use a modified inguinal lymph node dissection with intraoperative delivery of rapid freezing, which must be converted to radical inguinal lymph node dissection if positive. However, it is difficult to implement this method in China, firstly, the number of specimens for intraoperative rapid freezing is large, and whether the manpower and technology related to the pathology department in China can collaborate to achieve this; secondly, the number of lymph nodes in the inguinal region is large, and the frozen sections greatly increase the hospitalization cost of patients; the results of intraoperative frozen sections compared with postoperative conventional paraffin sections itself have a certain inaccuracy rate. Domestic patients with penile cancer have poor economic conditions and mostly come from rural areas, which cannot guarantee follow-up; once regional lymph node metastasis is missed, patients who could be cured by radical inguinal lymph node dissection surgery mostly become incurable due to delay. In view of the above, the radical inguinal lymph node dissection was improved, and for patients who need lymphatic dissection, the scope of radical dissection was adopted to ensure the effect of tumor control, while the surgical techniques such as S-shaped incision, use of anatomical landmarks to guide the flap separation in the correct plane, and complete preservation of the broad fascia were improved to reduce complications.