Background: Laparoscopic proximal gastrectomy with an anti-reflux procedure, as a function-preserving surgery, has been a common treatment strategy for proximal early gastric cancer. This study aimed to develop a new surgical technique for these patients. Methods: Laparoscopic proximal gastrectomy with vagus nerve preservation and double-flap technique was performed in patients who could retain two-thirds of the stomach. The hepatic branches and the celiac branches were both preserved. A seromuscular double-flap was created through the auxiliary incision, and the anastomosis was performed under laparoscopy. The detailed surgical procedure and preliminary results were presented. Results: Six patients underwent this procedure with no conversion to open surgery. No intraoperative and postoperative complications occurred during the perioperative period. No patients showed diarrhea and appetite loss, and body weight regained preoperative level 6 month later. No food residue and reflux esophagitis were observed via endoscopic examination. Gallbladder contraction was observed in all the patients by ultrasonography after high-fat diet. Conclusion: Although long-term follow up and a larger number of patients are required to evaluate the functional outcomes, this new technique provides a minimally invasive surgical option for proximal early gastric cancer, especially in the cardiac area.