With the advancement of minimally invasive techniques, the concept of membrane anatomy has propelled gastric cancer surgery toward the goal of complete mesenteric excision. Due to its unique anatomical location (adjacent to the cardia, esophagus, and diaphragm), upper gastric cancer presents significant surgical challenges, high complication rates, and ongoing controversies in treatment strategies. Ensuring the integrity of key mesenteric structures, such as the left gastric vascular mesentery, splenic vascular mesentery, and left inferior phrenic artery mesentery, constitutes the core prerequisite for improving therapeutic efficacy. By implementing the surgical strategy of “complete mesenteric excision”, combined with precise dissection along interfascial planes and vascular-guided operative principles, this approach effectively reduces intraoperative cancer cell spillage, decreases postoperative complication rates, and enhances the thoroughness of lymph node dissection alongside surgical safety.