尽管腹腔镜技术在我国右半结肠癌手术中广泛应用并取得显著进步，该手术因复杂的筋膜解剖结构、多变的血管变异、规范的淋巴结清扫范围以及消化道重建方式选择等核心环节，仍是制约手术质量提升和推广的关键挑战。本文结合我国最新研究进展、专家共识及本中心的实践经验，系统阐述腹腔镜右半结肠切除术的关键难点及优化对策，旨在为规范手术操作、提高手术安全性和肿瘤学疗效提供参考。

Despite the widespread use of laparoscopic techniques in right hemicolectomy for colon cancer in China and the significant progress made, key challenges remain. These include the complex anatomical structures, variable vascular variations, standardized lymphadenectomy ranges, and the selection of gastrointestinal reconstruction methods, all of which continue to limit the improvement and promotion of surgical quality. This article systematically elaborates on the critical difficulties and optimization strategies in laparoscopic right hemicolectomy, combining the latest research advancements, expert consensus, and the practical experience of our center. The aim is to provide a reference for standardizing surgical procedures, improving surgical safety, and enhancing oncological outcomes.