Abstract: In recent years, the incidence of upper gastric cancer has increased annually worldwide. Upper gastric cancer has become a huge threat to human health. Until now, total and proximal gastrectomies are still the most commonly used surgeries for upper gastric cancer. More attention has been paid to proximal gastrectomy because it retains the function of the stomach and has little effect on nutrient absorption. Patients who received proximal gastrectomy achieved better nutritional status. With the development of laparoscopic techniques, laparoscopic radical gastrectomy has been largely performed in gastric cancer treatment. Total laparoscopic surgery has been applied in the treatment of upper gastric cancer in recent years. However, this surgical procedure is still controversial in terms of the range of radical treatment and reconstruction of the digestive tract. Combining our own experiences, we will focus on the indications of total laparoscopic proximal gastrectomy and the guidelines for choosing the most reasonable procedure for digestive tract reconstruction.