OBJECTIVE: To investigate the effect of technical improvements in posterior laparoscopic radical nephrectomy on reducing the difficulty and risk of surgery and on reducing intraoperative and postoperative complications. METHODS: Sixty-one patients with early-stage renal cancer were treated with posterior laparoscopic radical nephrectomy. Preoperatively, the distribution of tumor vessels was determined according to the enhanced CT examination. During the operation, a 30° autofocus electron microscope and a homemade balloon dilator were used to establish the retroperitoneal space, and an ultrasonic knife was used throughout the separation to fully remove the extraperitoneal fat, and the peritoneum was protected as much as possible during the separation.