The health of the gastrointestinal tract is the foundation of our survival. It is especially important to take good care of the gastrointestinal tract, early detection of gastrointestinal tumors, and early treatment to maintain the health of our “life passage”. The higher the stage of tumor, the later the detection. According to foreign data, the 5-year survival rate of patients with early stage rectal cancer can reach 93%, while the survival rate of patients with advanced stage drops to 8%. The treatment of gastrointestinal cancer is mainly surgical, and the removal of the lesion and lymphatic clearance of the corresponding area is the only way to cure the tumor. Postoperative treatment with chemotherapy, radiotherapy and biological therapy greatly improves the efficacy and reduces the recurrence rate. Minimally invasive laparoscopic surgery has become one of the technical features, so that some patients with gastrointestinal cancer no longer need traditional open surgery that leaves a surgical scar of nearly 30 cm, but can complete radical surgery through only a few small holes of about 1 cm and a small opening of about 3 cm, with fast postoperative recovery, beautiful appearance, short hospital stay and low overall cost as its advantages. Three major advantages of laparoscopic surgery: 1. The laparoscopic camera has a magnifying effect. Compared with traditional open surgery, the field of view is clearer, so the operation is more accurate and fine, effectively avoiding unnecessary interference with organs outside the operation site, and less intraoperative bleeding, making the operation safer. 2.Less trauma and less postoperative pain. Generally, patients do not need to use painkillers after surgery, and the wounds can be treated with band-aids only, without removing stitches. High quality of life. Traditional surgery scar is long, laparoscopic surgery incision hidden, no obvious scars, local beauty, abdominal wall tough. 3. Quick recovery after surgery and short hospital stay. Early after surgery, you can turn over and move around freely, and the intestinal function recovers quickly, which greatly reduces the occurrence of intestinal adhesions. The next day after surgery, you can eat semi-liquid food and get out of bed, and resume normal life and work after one week. The following four cases introduce the specific process of laparoscopic treatment of gastrointestinal tumors: Case 1: Zhangww from Fujian, aged 68, came to Hangzhou from his hometown to visit his long-lost son in June. After learning that his father had poor bowel movement and loose stools for 1 year, which had been significantly aggravated in the past 4 months, his filial son brought his father to the hospital for medical treatment and found Director Xie of the Department of General Surgery, who examined and found a circumferential, hard mass in Mr. Zhang’s rectum with ulcerated and bleeding surface. Director Xie immediately realized that Mr. Zhang had rectal cancer, and the cancer was very close to the anus (only 7cm), so it was extremely difficult to perform radical surgery. The diagnosis was later confirmed through pathological examination. The son was devastated to learn that his father had cancer. He told Director Xie that his father had been strong all his life, and if he knew that he would have to have his anus removed and carry a fistula bag for the rest of his life, he would definitely refuse the surgery. As luck would have it, Mr. Zhang actually said that he would rather die when he learned that he might not be able to preserve his anus. The son pleaded with Director Xie to save his father, who has had a difficult life and has yet to honor him properly. Even if he had to spend all the money he had, he had to cure his father’s disease and let him enjoy his old age. Faced with this filial heart, Director Xie was in a difficult position. The treatment should not only save his life but also ensure a good quality of life. If an artificial anus was implemented, it would definitely affect his daily life in the future. However, the cancer was only 7cm away from the anus, so it was difficult to preserve the anus. Director Xie suggested radiotherapy to shrink the tumor first, and then laparoscopic surgery to ensure that the anus would not be removed. Three months later, after completing radiotherapy, Mr. Zhang returned to general surgery, by which time his tumor had shrunk significantly. At this time, there was still great difficulty in performing open surgery to preserve the anus. Director Xie decided to perform laparoscopic radical rectal cancer surgery for Mr. Zhang. Under the lumpectomy, the surgical field of view and operation space were expanded, allowing the resected intestinal tube to be extended 3 cm downward, and then a tubular anastomosis was extended through the anus to anastomose the severed end of the resected intestinal tube to the mucosa of the anal opening. In this way, Mr. Zhang was able to defecate through his own anus even after his recovery. The surgery was exceptionally successful, with minimal trauma and a quick recovery after surgery. One week after the surgery, he was already eating normally. On the day he was discharged from the hospital, his son was surprised to see his father’s athletic stride. He said his words of gratitude to Director Xie over and over again. Case 2: Chief Xie Song of the Department of General Surgery is an expert in laparoscopic surgery and gastrointestinal surgery who studied in Germany. 69-year-old Jin was one of the many patients who came to see him. Sister Jin has had gallbladder stones for more than 20 years, and the abdominal pain disease has been bothering her. Gallbladder stones are like a time bomb that can erupt at any time. However, she was afraid of surgery, and she was constantly told that surgery was a walk through the ghost gate. After learning that Auntie Li next door had just had a major surgery with Director Xie Song, she went home to live normally, in high spirits, and was dancing together in the square tomorrow. Jin Dajie made up her mind and found Director Xie, hoping he could help her overcome the disease. Through the results of the preoperative preparation, Director Xie found that Jin’s disease was not so simple: strong positive fecal occult blood and significantly elevated tumor markers. The next abdominal CT and colonoscopy results were even more surprising. In addition to gallbladder stones, tumors were found in Jin’s appendix and metastases in her liver. Jin regretted that she did not have regular medical checkups. Director Xie reassured her and told her that the tumor had metastasized and was in advanced stage, and although the surgery was difficult and it was not necessarily possible to remove the tumor, it was not completely impossible. Liver metastasis is the end-stage manifestation of colorectal cancer. The previous concept is that once liver metastasis occurs, there is no value of radical surgery and the prognosis is very poor. We use laparoscopy to visually explore the size and extent of tumor invasion in the abdominal cavity. In case extensive metastasis is found in the abdominal cavity, the trauma of surgical exploration has been minimized, and no matter what, treatment should be actively pursued. From my experience, it seems that the possibility of surgical resection is still extremely high. Jin’s family wanted to take a second look at other major hospitals. They went around with case information and eventually got very different results. Thinking of Director Xie’s consideration for herself in all aspects, she firmly told her family, “I only believe in Director Xie, and I will not go anywhere else if I want to have the surgery. The surgery went on as scheduled, and the procedure was arduous. Director Xie finally successfully completed the laparoscopic exploration + right hemicolectomy + cholecystectomy for Ms. Jin. Everything was as Director Xie predicted before surgery: appendix cancer, lymphatic metastasis and liver metastasis. The postoperative recovery was also as smooth as Director Xie predicted. Before she was discharged from the hospital, Ms. Jin said to Director Xie, “You have prediction function, you know everything. After saying that, both of them laughed. For doctors, rich clinical experience, skilled surgical skills and adequate preoperative preparation are the root of prediction. Case 3: Mr. Wang, who had always been physically strong, found himself with black stools, general weakness and dizziness all day for the past 3 days. Having never been in a hospital before, he was forced by his family to see a doctor in the hospital emergency department after nearly fainting. He was diagnosed with upper gastrointestinal bleeding of unknown origin. After aggressive medical treatment, the bleeding was largely controlled. Gastroscopy revealed a gastric body mesenchymal tumor. After a general surgery consultation, the bleeding was considered to be from the mesenchymal tumor and required surgical removal. On the same day, he was transferred to the surgical ward to prepare for surgery. On the afternoon of the day after being transferred to surgery, Mr. Wang again had black stools and his hemoglobin was dropping. After understanding his condition, Chief Xie of the Department of General Surgery made an immediate decision that the patient needed emergency surgery, otherwise, there was always the possibility of hemorrhage. In order for the patient to recover early, Director Xie decided to perform laparoscopic surgery on the patient. Director Xie called in the gastroenterologist and decided to perform intraoperative examination and localization. The mass was found precisely and removed accurately. During the operation, it was unexpectedly discovered that there was not one but two masses on Mr. Wang’s stomach. To the disbelief of Mr. Wang’s family, the surgery took only one hour. What was even stranger was that others had several tubes on their stomachs after the surgery, while Mr. Wang’s stomach had only a few 1-2cm and one 3cm wounds. One week after the surgery, Mr. Wang was discharged from the hospital healed. Director Xie told Mr. Wang that the disease you got was relatively rare and the bleeding was heavy, which was very dangerous at that time. At that time, it was hoped that you could recover early and chose laparoscopic surgery. I didn’t expect to find out unexpectedly during the surgery that you had not one, but two tumors. If you had an open surgery, you would not have seen it for sure. By choosing laparoscopy, it is possible to do better exploration, especially for rare or undiagnosed diseases like yours. Case 4: Mr. Yao, who was repeatedly troubled by stomach pain, had been taking medication, but without much effect. In the late afternoon of December 2 last year, he suddenly vomited blood and relieved black stool once, followed by syncope, panic, cold sweat and pale face, and was immediately sent to the hospital for consideration of upper gastrointestinal bleeding. The condition was stabilized after internal medicine treatment. Gastroscopy suggested gastric sinus cancer, and the pathological results confirmed the diagnosis. Mr. Yao, a native of Anhui province, was working in Hangzhou and had been neglecting his body. Knowing that he had cancer, he didn’t know what to do. He is the only son of his parents and has a couple of children who are not yet adults. He had to get himself well quickly. The doctor told him that you need to be transferred to surgical treatment, which he gladly accepted and hoped to operate quickly and recover quickly. After understanding his condition, the chief of general surgery, Mr. Xie, decided to perform laparoscopic surgery on Mr. Yao. However, the cost of the surgery put Mr. Yao in a difficult position. The cost of laparoscopic surgery is definitely higher than that of open surgery, and for him, who came to Hangzhou from abroad to work, the money for treatment is saved little by little and is life-saving money. Director Xie shook his head and said with a smile, you only see the lumpectomy is bad. Doing laparoscopic surgery is less traumatic, faster recovery after surgery, and the post-operative treatment costs are reduced, so the overall cost does not increase. The key step of gastric cancer surgery is to clear the surrounding lymph nodes, which will be hidden. With laparoscopy, the surgical exploration field is magnified 5-10 times and the clearance is complete, in other words, the surgery is done more cleanly and recurrence is reduced. In fact, the choice of laparoscopy increases the difficulty of the surgery for the surgeon. After listening to Director Xie’s explanation, Mr. Yao nodded silently, and on December 10, Director Xie successfully completed laparoscopic radical gastric cancer surgery (distal gastrectomy + Bi-II anastomosis + regional lymph node expansion and clearance) for Mr. Yao. Just 10 days after the operation, Mr. Yao recovered and was discharged from the hospital. Before he was discharged, he told the patient in the next bed that it was good that he listened to Director Xie and chose laparoscopic surgery, otherwise, he would not have recovered so easily and might still be unable to move in bed now.