1. Brief history: Female, 21 years old, was admitted to the hospital with chest discomfort for one week. Chest CT: The tumor was located in the anterior superior mediastinum, favoring the right side of the chest cavity, with a size of about 5×6×7 centimeters, clear and smooth borders, clear boundaries with the right and left innominate veins, superior vena cava, aortic arch, pericardium, uneven density, and cystic solidity. Preoperative diagnosis: anterosuperior mediastinal tumor, considering the possibility of benign. Proposed treatment: Lumpectomy of anterosuperior mediastinal tumor through the right chest. 2. Surgical introduction: The mediastinal pleura was incised circumferentially at the base of the tumor, and the tumor peritoneum was found to be intact and there was a thick vein returning to the anteromedial aspect of the superior vena cava (slightly below the confluence of right and left innominate veins), which was released proximally by a hemo-lock, and was cut off by ultrasonic scalpel. The dissection of the tumor envelope is continued, with membranous connective tissue between the tumor and the envelope, and a combination of blunt and sharp detachment frees the tumor. Finally, only a broader tip was attached to the tumor, which extended deeper into the hiatus surrounded by the left innominate vein, aortic arch, cephalic brachial trunk, and left common carotid artery. The connective tissue around the tip was carefully cut off, and the remaining diameter of the tip was about 1.5 centimeters, which was cut off by ultrasonic scalpel in several stages, and the tumor was completely resected. 3. Experience: The whole operation was smooth and fluent, which can be called a classic of laparoscopic mediastinal surgery. The reason why the surgery could be carried out smoothly has a lot to do with the placement of the body position and the correct selection of the operation hole and mirror hole. This patient’s tumor was huge and located in the narrow anterior superior mediastinum, so if the surgical field could not be well revealed, the surgery could not be performed at all. The following is a description of the position and hole selection for this surgery: the anterosuperior mediastinum tumor was biased to the right side, so the right thoracic approach was chosen. First, the patient was placed in a lying position with the right side of the chest and back elevated at an angle of approximately 30 degrees to the horizontal. The advantage of this is that, under the influence of gravity, the right lobe of the lung is displaced backward and downward, and the tumor is displaced forward and downward, presenting a good surgical field without the need for pulling. Secondly, it is the selection of the operation hole and the mirror hole: the main operation hole of the procedure was selected at the third intercostal axillary line, about 4 cm in length, the secondary operation hole was selected at the fifth intercostal axillary line, about 2 cm in length, and the mirror hole was selected at the fourth intercostal axillary line, about 1.5 cm in length, and the connecting line of the three holes was in the shape of a triangle. The reason why the holes were chosen in this way was because it revealed the surgical field well and facilitated the surgical operation. In fact, there is no specific rule for the placement of the body position or the selection of the holes, but the principles that must be followed are good visualization of the surgical field and convenient surgical operation. The above hole positions are roughly distributed in the anterior upper third of the line connecting the right anterior axillary line and the posterior axillary line. Because the main body of the tumor is located in the anterior superior mediastinum, 3, 4 and 5 intercostal spaces are chosen, which can cross the right lung lobe very well, so that the operator’s field of view covers the tumor in a fan shape, which lays the foundation for the smooth resection of the tumor.