The kidney is a solid organ, and common tumors of the kidney include renal parenchymal tumors and tumors of metastatic epithelial origin in the renal pelvis. The surgical treatment of renal parenchymal tumors mainly includes radical nephrectomy, partial nephrectomy with preservation of renal units and inferior vena cava tumor embolization and embolization for renal cancer. With the development of modern imaging and laparoscopic technology, more and more renal tumors can be accomplished by minimally invasive surgical methods such as laparoscopy, freezing and ablation, but open surgery still has an irreplaceable status. For huge kidney cancer, kidney cancer with inferior vena cava thrombosis and medical units that cannot perform laparoscopic surgery due to technical conditions, open surgery is still a safe and reliable treatment option. The anatomical location of the kidney differs from left to right, and the adjacent organs around the two sides of the kidney are also different. If an anterior approach via the abdominal cavity is adopted, it is necessary to be familiar with the anatomical differences between the left and right sides. There are certain differences in the length of the arterioles and veins of the kidneys on both sides, and the branching of the veins are also different, so when these vessels are exposed and treated during surgery, the corresponding operation methods should be used according to the different anatomical characteristics. There are various approaches to renal surgery reported in the literature, and in general, they can be divided into the lateral posterior extraperitoneal lumbar approach, the anterior abdominal approach and the combined thoracoabdominal approach. According to our experience, for renal tumors, laparoscopic or trans-lumbar incision can be used for limited renal cancer, while trans-abdominal or combined thoracoabdominal approach is appropriate for locally progressive tumors, giant renal tumors and renal cancer with inferior vena cava thrombosis.