Objective To discuss key points of surgical cooperation in laparoscopic radical resection of high rectal cancer with transvaginal specimen extraction and without abdominal incision, so as to provide valuable experience and reference to better cooperation in this surgical method and other similar surgical methods. Methods Clinical data and surgical cooperation of 16 patients undergoing this surgical method were analyzed retrospectively, with key points of the operation nursing summarized. Results All the 16 patients tolerated general anesthesia and carbon dioxide pneumoperitoneum, which made smooth surgeries without conversion to laparotomy and adverse reactions. All the patients were cured and left the hospital with fine condition of recovery. Conclusions Full preoperative preparation of nurses, familiarity of surgical process, good command of laparoscope instruments, usage of special instruments, and rigorous non-bacteria and non-tumor technique operation, are all keys to a successful operation.