Patient L, male, 63 years old, right nephrectomy 13 years ago, was found to have left upper pole renal cancer 2 weeks before admission to our hospital (picture). The creatinine of renal function had reached 132umol/ml, suggesting that the renal function was already bad. Originally, patients with renal cancer of isolated kidney should actively undergo surgery while preserving the residual kidney, because if the kidney preservation surgery is not performed, the patient will be on long-term hemodialysis, and the quality of life will definitely be significantly reduced, and the cost of medical treatment will be greatly increased. However, for this patient, if the surgery to preserve the kidney unit is performed: first, the patient’s kidney tumor is located in the upper pole of the kidney (increased surgical difficulty); second, the tumor is very close to the collecting system and accidentally loses the renal pelvis, etc., it is likely to leak urine for a long time after surgery and the wound will not heal; third, the kidney tumor is relatively large, larger than the conventional 4 centimeters; fourth, the patient’s kidney function is already abnormal before surgery, which may increase the possibility of long-term non-healing of the surgical incision, etc. The possibility of long-term non-healing, etc. Moreover, even if the kidney unit is successfully preserved, there is still a possibility that the result will not be achieved after surgery. These unfavorable conditions for surgery put both our doctors and patients in a dilemma. Obviously, if radical surgery is performed without preserving the kidney unit, the consequence is self-evident that long-term dialysis treatment must be performed, and the patient will surely suffer from great pain and financial burden! Of course this is the least stressful for the doctor. On the contrary, if the surgery to preserve the kidney unit is performed, firstly, the surgery is very risky, in case the kidney bleeds again after the surgery, there is a second surgery to remove the kidney, which is not only painful but also not understood by the patient; secondly, even if the surgery to preserve the kidney is successful, if the residual kidney unit cannot function after the surgery (because the patient’s kidney function is already bad before the surgery), dialysis is still needed. Fortunately, when we told the patient and his family all the facts, they showed great trust and understanding to us, which strengthened our confidence in the surgery! The whole department under the leadership of Prof. Tang Xiaoda and Prof. Xia Jiji repeatedly held several department-wide discussions, and together with the Department of Anesthesiology, the Department of Nephrology and the Hemodialysis Unit, we formulated a strict surgical plan and various pre-surgical preparations, perfected the possible emergency treatment plan after surgery, and also carefully communicated with the Interventional Department to prepare for interventional treatment for post-surgical bleeding. Fortunately, although there were many vessels in this patient’s renal tumor, there were multiple branches assigned to the kidney as well as the tumor, giving me the possibility to perform laparoscopic superselective arterial block to preserve the renal unit. With the close cooperation of the whole department comrades and anesthesiologists, Dr. Fan Jie performed the laparoscopic renal artery superselective block method to preserve the renal unit on December 15, 2015, and the operation was very successful. Although the renal tumor was relatively large, the pathology of the excised tumor suggested that there was no residue of tumor at the cut edge. The patient was discharged from the hospital smoothly, and the current blood creatinine is about 150umol/ml, blood electrolytes are in normal range, and daily urine output is about 1800ml. At present, the patient’s blood creatinine is about 150umol/ml, blood electrolytes are in normal range, and daily urine volume is about 1800ml. When it comes to the doctor-patient relationship, we are very impressed by the high level of trust and understanding of the patient, which became a great spiritual motivation for us to fulfill our duty of saving lives and helping the injured. And whether we ourselves are highly skilled and at the same time have the courage to be willing to take risks and be able to serve our patients sincerely is also an important party to improve the doctor-patient relationship.