In recent years, with the maturation of laparoscopic surgical skills, development of 3D high definition laparoscopic video technology, and the innovation of medical hemostat instruments, laparoscopic pancreatoduodenectomy (LPD) has been widely used in clinical practice, and its feasibility and safety were also recogniczed. LPD has also been used in the treatment of carcinoma of head of pancreas. R0 resection for open pancreatoduodenectomy for pancreatic cancer, such as the combined portal vein/SMV resection and arterial first approach, has also been widely used in LPD, and the advantages of LPD combined with arterial first approach have been recognized by more and more surgeons. In order to increase the R0 resection rate of carcinoma of head of pancreas and to reduce the risk of bleeding during the uncinate process, the author refered the intestinal derotation artery first approach in OPD, and further proposed a new artery fisrt approach in LPD, calling semi-Derotation artery fisrt LPD. This article will discuss the application and feasibility of this procedure of Semi-Derotation artery fisrt LPD, and discuss its clinical significance.