What is the concept of “minimally invasive” gynecology? As we all know, surgery itself is a “double-edged sword”, which is used to cure internal diseases through artificial trauma. The correct concept of minimally invasive emphasizes the rational application of different techniques to achieve the best treatment results with minimal tissue and organ damage, minimal inflammation, and optimal scar healing. Therefore, minimally invasive is a concept, not just a “small wound”. Nowadays, the concept of “minimally invasive” is undergoing a qualitative change, gradually developing from the biomedical level to the biomedical-social-psychological level, and minimally invasive meets the requirements of humanistic thinking (spirituality, morality, aesthetics). What are the main types of minimally invasive gynecological surgery? At present, minimally invasive gynecological surgery can be broadly divided into two camps, cathodic and lumpectomy. Other minimally invasive techniques: radiofrequency ablation technique, gynecological vascular interventions and gynecological ultrasound interventions. We will briefly introduce each of the major minimally invasive techniques one by one. One of the representatives of minimally invasive gynecologic techniques is also our leading technique: gynecologic laparoscopy Laparoscopy is a recent emerging technique, which is a revolution in surgical techniques and is flourishing worldwide. The lens of the laparoscope has a magnifying effect of 8-10 times, so the images that the surgeon can see during laparoscopic surgery are much clearer than during traditional open surgery. In the 21st century, with the continuous improvement of surgical instruments and equipment and the continuous improvement and maturation of surgical techniques, the more complicated gynecological surgeries can be performed smoothly under laparoscopy. The indications for laparoscopic surgery are becoming more and more extensive. It has replaced most traditional gynecological open surgery and become the most widely used, most effective and most promising “minimally invasive gynecological” surgery, which is a great milestone in modern gynecological treatment. In gynecology, except for malignant tumors, which are controversial, almost all surgeries can be performed, and the most common surgeries are: 1. Pelvic inflammation and pelvic abscess; 7. Pre-operative diagnosis of chronic pelvic pain of unknown etiology, masses of unknown nature, ovarian tissue biopsy, etc.; 8. Correction of various genital tract anomalies, including congenital absence of vagina, hermaphroditism, stump uterus, etc.; 9. Some early malignant tumors, such as: endometrial cancer, cervical cancer, ovarian cancer, etc. The second representative of minimally invasive gynecological technology, gynecological hysteroscopy technology Don’t look at the inside of the female uterus, although the space is small, but there may be various dangerous lesions. In the past, many women did not know enough about lesions in the uterine cavity, and physicians had certain doubts and misunderstandings in identifying, locating and treating lesions. For example, the use of hysteroscopy in the international medical community has revolutionized the surgical removal of the entire uterus for unexfoliated submucosal fibroids, abnormal abnormalities in the uterine cavity or residual foreign bodies in the uterine cavity. Hysteroscopy is the use of a mirror to enter the uterine cavity through the natural orifice of the woman’s vagina and cervix to perform diagnostic and surgical procedures. The implication is that hysteroscopic surgery does not even involve a tiny wound in the abdomen and offers greater advantages over laparoscopic surgery with virtually no postoperative pain and a faster recovery. So what kind of surgeries are suitable for gynecological hysteroscopy technology Hysteroscopy technology, the biggest advantage, can be performed under direct vision for the diagnosis of various diseases in the uterine cavity, such as endometrial polyps, submucosal fibroids, submucosal fibroids in the intermucosal image, uterine adhesions, longitudinal uterus, etc.. It can also perform direct microscopic cannulation for proximal tubal obstruction, separation of uterine cavity adhesions, myoma and polyp removal and electrodesissection, and electrodesissection of endometrium and longitudinal uterus. Classic minimally invasive gynecologic technique gynecologic transvaginal surgery Gynecologic transvaginal surgery uses the vagina, a natural cavity, to access the pelvic cavity for surgery. Transvaginal surgery is a surgical procedure with a very long history in gynecological surgery. Because it is done transvaginally, there is less tissue trauma, less interference with the abdominal organs, relatively few complications inherent to the surgery itself Less harmful complications; less pain after surgery, no visible scar on the abdominal wall, and more in line with the minimally invasive concept compared to the laparoscopic three to four holes in the abdomen. Its superiority has been recognized in the past and in modern times. Almost all gynecological surgeries can be performed using the natural orifice of the vagina as long as one has a solid basic knowledge of cathodic surgery. However, it has its shortcomings, such as narrow field, poor visualization and difficult operation. If the uterus is too large (more than 12 weeks of gestation), or if the uterus has pelvic mirror adhesions, the complications will increase significantly. With the development of laparoscopic technology, many complex transvaginal surgeries can be done with the assistance of laparoscopy. In recent years, more attention has been paid to transvaginal surgery at home and abroad, and its indications have been greatly expanded. Therefore, for some patients with difficult surgeries, our doctors will combine both surgical methods to better facilitate the completion of the surgery. Therefore, as a gynecologist, we must master a variety of techniques to complement each other’s strengths and weaknesses in order to truly benefit our patients. Gynecologic vascular intervention Interventional radiology is a “non-surgical” method of diagnosing and treating related diseases by percutaneous puncture and cannulation under the guidance of imaging methods, such as drug infusion, vascular embolization or puncture biopsy, and vasodilatation and angioplasty. Interventional treatment gives obstetric and gynecologic patients more treatment options, and under certain conditions, they can avoid the pain of opening the abdomen or removing the uterus, improve the effectiveness of disease treatment, and truly appreciate the minimally invasive advantages of vascular interventional treatment. Uterine artery embolization is the core technology of obstetrical and gynecological interventions. Since it was first used to treat uterine fibroids in 1995, it has been used as an alternative treatment to hysterectomy and myomectomy as well as drug therapy, with better efficacy, preservation of the uterus and less recurrence, especially for relieving dysmenorrhea caused by adenomyosis and improvement of anemia caused by fibroids. Uterine artery embolization is applied to the treatment of cervical/angle pregnancy, incisional pregnancy, placenta placement and other diseases, and is combined with postoperative clearance to preserve the uterus and retain reproductive function with significantly reduced risk of hemorrhage and shorter hospital stay. For IVF patients with tubal effusion, laparoscopic or open tubal resection has been used in the past, requiring hospitalization and relatively high costs. Embolization of the proximal part of the isthmus with a microspring coil can be done on an outpatient basis, with definite efficacy, without anesthesia, and at relatively low cost. Embolization significantly reduces miscarriage due to reflux of fluid into the uterine cavity, increasing the success rate and significantly reducing the risk of ectopic pregnancy. Misconceptions of minimally invasive concept Minimally invasive is the direction of surgical development in the 21st century, but here we should also emphasize that there are positive and negative sides to everything. Minimally invasive surgery in the field of gynecology, like traditional surgery, requires higher requirements from the surgeon, who must have a good anatomical foundation, more skillful clinical skills than traditional surgery, and excellent medical ethics as a prerequisite. We do minimally invasive things through a minimally invasive pathway, through a small hole in the abdominal wall. Once we do not operate well, the minimally invasive may become heavily or massively invasive, which is passive. Therefore, in today’s rapid development of science and technology, doctors should keep up with the times, keep learning and improving, and develop a skillful technique, so that they can be familiar with the operation and handle it freely, and avoid blindly carrying out minimally invasive surgery, which leads to the failure of the operation and the waste of medical resources. Doctors and patients have entered the “minimally invasive misunderstanding”.