In recent years, with the continuous progress of science and technology, the development, updating and improvement of surgical instruments, miniaturized surgical equipment and operating instruments with less damage to patients have been gradually applied in microsurgery and gynecological surgery, and new energy systems such as intelligent electrocoagulation system, ultrasonic knife, vascular closure system and “Z knife” have been introduced one after another, making the clinical application of laparoscopic technology more and more mature and extensive, and greatly improving the safety of laparoscopic surgery. The safety of laparoscopic surgery has been greatly improved. At present, the indications for laparoscopic diagnosis and treatment have been relatively broadened and the contraindications relatively narrowed, so that this technology has gradually entered a new era of minimally invasive surgery. Indications for laparoscopic surgery The indications for laparoscopic surgery include the indications for surgery and the physiological status suitable for laparoscopic surgery. At present, most of the surgeries in the field of gynecology can be performed laparoscopically, but the scope of indications for laparoscopic surgery must be determined according to the physiological condition of the patient, the equipment condition of the hospital, the technical level of the operator, the monitoring facilities of anesthesia and other comprehensive factors: (1) early diagnosis of ectopic pregnancy along with tubal incision and retrieval or removal of the fallopian tubes. (2) To perform pathogenic examination of pelvic infectious diseases and perform simultaneous pelvic adhesion decomposition, abscess incision and drainage, and tubo-ovarian cyst opening or resection. Perform tuboplasty and tubal ostomy at the same time as the diagnosis of the etiology of infertility. (3) Electrocoagulation destruction surgery of endometriosis lesions or lesion removal surgery. (4) Opening and drainage of pelvic masses and ovarian cysts, ovarian tumor exfoliation, adnexal resection, and resection of tubal tract cysts. (5) Total hysterectomy or myomectomy for uterine fibroids, adenomyoma and adenomyosis. (6) Surgery for malignant tumors of the reproductive tract: surgery for early endometrial cancer, cervical cancer, ovarian cancer, including radical hysterectomy, pelvic and para-aortic lymph node dissection, omentum and appendectomy. (7) Diagnosis and treatment of genital tract abnormalities. (8) Family planning: IUD removal, uterine perforation repair, tubal ligation, tubal anastomosis. (9) Reproductive fertility: Mature egg aspiration, gamete intrafallopian tube transplantation, polycystic ovary puncture and perforation. (10) Orthopedic surgery for pelvic floor dysfunction: retropubic vesicourethral suspension. Laparoscopic surgery in clinical practice Laparoscopy for ectopic pregnancy is the gold standard for the diagnosis of ectopic pregnancy. Its significance is that when ectopic pregnancy is highly suspected clinically, laparoscopy should be performed as early as possible to clarify the site of pregnancy, the degree of destruction of the fallopian tube on the focal side, and intra-abdominal bleeding. The decision on the surgical procedure is then based on the stability of the patient’s vital signs, the patient’s age and whether she has fertility requirements. For patients with hypovolemic shock due to intra-abdominal hemorrhage caused by ectopic pregnancy, laparoscopic surgery under general anesthesia is recommended as soon as possible while actively correcting the shock. Tubectomy for embryo retrieval is mainly used in patients with tubal pregnancy who need to preserve their reproductive function and whose fallopian tubes are not significantly damaged. However, in the case of ruptured tubal pregnancy, since the normal structure of the fallopian tube has been destroyed, preservation of the fallopian tube is of no value for future reproductive function, and therefore tubectomy for embryo retrieval is not recommended. Tubectomy is mainly used in patients with ruptured tubal pregnancy who have no need to have children or whose normal structure of the fallopian tube has been destroyed. Tubal cystoplasty is performed for total or partial atresia of the fallopian tube due to adhesions at the umbilical end of the tube, but the structure of the umbilical end has not been destroyed. Through tubal lavage, the fluid containing melanin flows under pressure from the small central hole of the umbilical end of the fallopian tube and is cut open along the hole to reach the lumen of the fallopian tube. Patients with intact tubal umbilical structures have a high postoperative pregnancy rate. If the tubal end is obstructed with fluid and the normal structure of the umbilical end has disappeared, the end of the tubal is distended after tubal lavage and the end of the tubal is cut in a “*” radial pattern at the central depression of the tubal, the edge is turned out and fixed with sutures on the plasma surface of the tubal. Tubectomy In patients with hydrocele, the fluid in the lumen of the tube returns to the uterine cavity, which may decrease the success rate of embryo transfer and may increase the rate of ectopic pregnancy later on. In addition, in patients with thin-walled hydrocele, the pregnancy rate is low after endovarian tube ostomy. After tubal ligation, the tubal blockage should be removed by electro-acupuncture, and the tubal end of the tubal tract should be sutured together with stitches on the opposite side and both sides. Endometriosis can be diagnosed based on history, physical signs, and ancillary examinations, but laparoscopy and biopsy for pathological examination is the most intuitive and accurate method of diagnosis. Pelvic endometriosis lesions have a variety of morphological appearances and are classified as pigmented lesions with black, dark brown, brown, and purple-blue nodular plaques. Hemorrhagic lesions are red lesions, which may have blood blisters, polyps, and hemorrhagic types, which are mostly surrounded by vascular hyperplasia or congestion. Papular or blistering lesions are translucent or pink glandular or vesicular structures that protrude from the peritoneal surface, mostly on the surface of the uterosacral ligament, the rectal trap of the uterus, and the ovaries. There are also white or colorless plaque-like scar lesions and peritoneal defects caused by contraction of peritoneal fibrous scar. Laparoscopy has a magnifying effect and makes it easier to identify localized lesions. Ovarian endometriosis can form cystic endometrioid cysts. The ovarian surface is often adherent to the surrounding tissue and the cyst contents are chocolate like viscous fluid hence the name. When the fluid in the cyst gradually increases and the cyst pressure increases, rupture may occur and coffee colored chocolate like fluid may flow out. The cyst often adheres to the lateral peritoneum, the posterior wall of the uterus and the fallopian tubes.