With the development of painless gastrointestinal endoscopy and surgical techniques, more and more elderly patients with coronary heart disease can undergo gastrointestinal surgery. Preoperative preparation and evaluation, surgical methods, and intraoperative anesthesia management are important to perioperative safety and rapid recovery. This patient had severe coronary heart disease (three‑vessel disease), incomplete intestinal obstruction, old cerebral infarction, mild anemia, and hypokalemia before operation. This patient followed the enhanced recovery after surgery strategy in the perioperative period, the surgeon chose the minimal invasive robot‑assisted laparoscopic surgery, anesthesia was conducted to optimize the balance of myocardial oxygen supply and demand. The patient completed the surgery and successfully discharged.