Minimally invasive laparoscopic techniques began to be widely used in the 80s and 90s of the last century. 1987, Mouret of France firstly reported the TV laparoscopic cholecystectomy, which opened a new chapter of modern minimally invasive surgery, and in February 1991, Xun Zuwu completed the first case of laparoscopic cholecystectomy in China. The outstanding representative of modern minimally invasive surgical technology – TV laparoscopic technology, known to the medical profession as the end of the 20th century, the field of photoelectricity, modern high-tech and modern surgery organic combination of a new technology revolution in the field of surgery, is a new milestone in the history of modern surgical development. First, the history of the development of gynecological laparoscopy gynecological laparoscopy technology is constantly developing and progressing, it has gone through three stages: (a), pelvic mirror 1901 Russian gynecologist D.O. ott also cut the posterior vaginal dome under the illumination of the frontal mirror into the cystoscope to observe a woman’s abdominal cavity. This was the first case of pelvicoscopy. (ii), diagnostic laparoscopy in 1910 Jacobaeus.H.C first applied the trocar puncture needle inserted into the abdominal wall and through the trocar air into the abdominal cavity, and then put into the cystoscopy for examination. 1944 France’s Raoul Palmerjiang laparoscopy formally used in the field of gynecology, to a large number of infertility patients to do the examination and the development of the operation of laparoscopy routine. In 1963 published a monograph, a systematic introduction to laparoscopy some relatively simple operations, such as: tubal ventilation, ventilation; simple separation of visceral adhesions; tubal electrocoagulation sterilization; endometriosis electrocoagulation, electrocautery and so on. (C), surgical laparoscopy into the 70’s due to the invention of cold light source, glass fiber endoscopy, Germany Semm artificial pneumoperitoneum monitoring device — automatic pneumoperitoneum machine came out, so laparoscopic surgery sensationally developed. Because of its small damage, without the need for a caesarean section, it was quickly accepted by both doctors and patients.In 1980, Dr. Nezhat of the United States began to use television laparoscopy for surgery. In 1980, Dr. Nezhat started to use TV laparoscopy in the United States, so that the surgical field is clearly shown on the screen, expanding the field of view, many doctors can see the surgical process at the same time, which is conducive to technical exchanges and discussions, and also facilitates the cooperation of assistants and anesthesiologists.In the late 80’s, Prof. Kurt Semm of Germany invented and created a lot of new surgical instruments and techniques. Such as: microscopic suture instruments, irrigation pump, various pliers, scissors, combined crusher, cutter and so on. Nowadays, there are various means of hemostasis under the microscope: unipolar electrocoagulation, bipolar electrocoagulation, ligature collar, internal suture technology, titanium clips, anastomosis and other technological advances to make the more complex surgery completed under the microscope. In 1988, Reich H did the first laparoscopic total hysterectomy, since then the scope of gynecological surgery more and more, almost 90% of gynecological surgery can be completed laparoscopically. China’s laparoscopic surgery started late, in 1979 in the United States Laparoscopic Association under the leadership of Jordan Phillips, chairman of the first laparoscopic surgery, so far has reached the world’s advanced level. Second, gynecological laparoscopic surgery equipment equipment includes: light source, conduction system and endoscope, television recording system, inflatable device that is CO2 pneumoperitoneum machine, electrosurgical instruments, flushes and operating components. Third, gynecological laparoscopy operation skills: (a), the basic operation skills: 1, position gynecological laparoscopy using head-low hip-high 15-30 degrees. 2, puncture site selection into the mirror position selection of the umbilicus most commonly used, estimated pelvic mass is large or surgical scar to reach the umbilical cord edge, should choose the upper edge of the umbilicus, this is the abdominal wall of all groups of musculofascial confluence, the thinnest. 3, pneumoperitoneum formation After determining the site of puncture, use a 6mm pointed scalpel to insert 2mm and then pick the skin upward for about 1cm, and use two scarf clamps to hold and lift the abdominal wall next to the umbilicus, so that the abdominal wall is away from the omentum and the intestinal tube. Slowly enter the abdominal cavity and inject gas. 4, set the mirror to observe the decision of the operation 5, select the operation hole puncture (b), electrosurgery application skills: electrocoagulation is one of the most commonly used hemostatic methods in laparoscopic surgery. Including: cauterization, coagulation, vaporization (3), the operation of microscopic suture knotting skills Microscopic suture is the most complete hemostasis method, the beginner is extremely difficult. The first suture knot, it may take 20-30 minutes, but when you once mastered the mirror suture knotting technology, laparoscopic surgery can be at your disposal. (D), ligature technique The principle of ligature is to slip the knot generally by the manufacturer to provide ready-made ligature coil. Fourth, gynecological laparoscopy indications: 1, a variety of unspecified causes of abdominal pain 2, more difficult abortion laparoscopic supervision and diagnosis and treatment of complications 3, infertility etiology examination 4, endometriosis clinical staging Fifth, gynecological laparoscopy surgical scope: 1, benign ovarian tumor resection 2, uterine fibroids removal 3, hysterectomy 4, pelvic adhesion disintegration surgery 5, ectopic pregnancy tubal Cutting and embryo extraction 6, ectopic pregnancy tubectomy 7, polycystic ovary syndrome ovarian wedge resection, laparoscopic perforation 8, tubal sterilization 9, endometriosis lesion biopsy, electrocautery 10, pelvic stasis round ligament shortening 11, uterine malignant tumors surgery (radical total hysterectomy, pelvic lymph node dissection) 6, laparoscopic surgery characteristics: 1, the operation is under the observation of the speculum The operation is performed under the observation of speculum to remove the lesion, without the need of conventional incision surgery, fine operation with little damage, fast recovery, small incision without suture and short hospitalization time. 2.The lesion must be clearly observed through the speculum, and long forceps are used to go into the body cavity through the cannula to carry out operations such as separation, stripping, ligature and excision. 3, in order to reveal the surgical field clearly, easy to operate, must be injected into the abdominopelvic cavity with a large amount of CO2 gas and the head-low hip-height position. Seven, laparoscopy in gynecology in the specific application 1, in the diagnosis of infertility in the application of laparoscopy in infertility in the main role is to diagnose and deal with the fallopian tube and abdominal factors caused by infertility, these factors are mainly inflammation (including tuberculosis) and endometriosis. Diagnostic laparoscopy and tubal fluids can be used to directly visualize the internal genitalia and to obtain information about the patency of the tubes, and are therefore considered the most effective tools for confirming adhesions in the adnexal area and endometriosis. 2.Application in the diagnosis of abdominal pain Abdominal pain is one of the most frequently encountered clinical symptoms, and in the gynecological category, abdominal pain mainly refers to lower abdominal pain. Distinguished by time: acute abdominal pain, chronic abdominal pain (cyclic, persistent). In acute abdominal pain, the causes originating from the reproductive system are: 1. pregnancy-related: miscarriage, ectopic pregnancy; 2. tumor-related: ovarian cyst torsion or rupture, uterine fibroids degeneration or torsion; 3. inflammation-related: acute pelvic inflammatory disease; 4. others: rupture of the corpus luteum of the ovary, ovarian hyperstimulation syndrome, dysmenorrhea and menstrual reflux and so on. In chronic abdominal pain, it can be divided into two main categories: 1, cyclic chronic abdominal pain whose onset of pain is related to the menstrual cycle. Such as midmenstrual pain and dysmenorrhea; 2, the onset of pain is not related to the menstrual cycle of non-cyclical chronic abdominal pain. Such as pelvic inflammatory disease, pelvic adhesions, endometriosis. 3.Application in the diagnosis of pelvic masses From the perspective of pure diagnosis, some of the means currently used in clinical practice, such as CT, MRI and ultrasonography, have been able to satisfy the general needs, that is, they can determine whether or not a mass exists. Therefore, for benign pelvic masses, the role of laparoscopy is not in diagnosis, but in surgery, that is, whether the mass can be removed laparoscopically. For gynecologic malignancies laparoscopy has four main roles: 1, evaluation of ovarian tumors; 2, diagnosis and staging of ovarian cancer; 3, post-treatment detection; 4, staging of pelvic or para-aortic lymph nodes. The above diseases are visualized at a glance under laparoscopy. The vast majority can be treated with laparoscopic surgery at the same time. Eight, complications of laparoscopic surgery Laparoscopic surgery and open surgery as there is also the problem of complications, so rapid diagnosis and appropriate treatment of complications is very important. The main complications are: 1, anesthesia accident; 2, venous air embolism; 3, extraperitoneal hyperinflation or emphysema formation; 4, electrothermal injuries; 5, vascular injuries; 6, organ injuries; 7, other: nerve injury, infection, abdominal wall hernia. Nine, the future of laparoscopic surgery Laparoscopic minimally invasive surgery has a variety of advantages that determine the inevitable development. As the surgery causes less damage to the patient, less pain, shorter hospitalization time, and quicker postoperative recovery, it reduces the medical burden on the government, insurance agencies and patients, and promotes and improves the social benefits of the country while reducing the expenditure on medical costs.