【Abstract】Objective: To investigate the application of hand-assisted laparoscopy in gynecologic surgery. Methods The experience of 23 cases of hand-assisted laparoscopy between April 2003 and July 2005 in our hospital was retrospectively analyzed. Various circumstances of performing hand-assisted laparoscopy such as type of disease, indications for surgery, intraoperative bleeding, operative time, postoperative recovery and immediate and long-term complications were analyzed. RESULTS Out of 23 cases, 22 cases were successfully completed and 1 case was converted to open surgery. Most of the cases were patients with severe pelvic adhesions that usually require conversion to open surgery. The average intraoperative bleeding was 63±45.3 (20–200) ml,the average operative time was 89.1±25.6 (45–180) minutes, and there were no serious intraoperative or postoperative complications. Postoperative patients had mild pain and quick recovery, and the average postoperative hospitalization was 4.05±1.7(1–7) days. There were no distant complications in the postoperative follow-up of 3 to 30 months. Conclusion Utilizing hand-assisted laparoscopic technique can synthesize the advantages of open surgery and laparoscopic surgery to achieve minimally invasive purpose. 【Keywords】 Laparoscopic surgery, pelvic adhesions Hand-assisted Laparoscopic Surgery (HALS) is a new technology developed internationally in recent years, and has been used in a variety of surgical procedures. Hand-assisted Laparoscopic Surgery retains the advantages of minimally invasive laparoscopic surgery, and reduces the difficulty and risk of laparoscopic surgery, and is more flexible. Flexibility. It has not been reported to be used in gynecological surgery. In our hospital, 23 cases of hand-assisted laparoscopic surgery were applied between April 2003 and July 2005, and good therapeutic effects were achieved, which are now reported as follows, in order to explore the clinical significance of its application in the field of gynecological surgery. Clinical data There were 23 cases in this group. The average age was 37.5 (30-49) years old. There were 13 cases of endometriosis, uterine adenomyosis, and ovarian chocolate cysts, 8 cases of chronic pelvic inflammatory disease, and 2 cases of previous history of tuberculous peritonitis.Of the 23 patients, 14 had a history of previous surgery: 7 cases of previous laparoscopic gynecological surgery, 2 cases of cesarean section, 4 cases of gynecological open surgery, and 1 case of surgical abdominal surgery.Thirteen out of the 23 patients were patients with infertility. All patients were combined with severe pelvic adhesions. Surgical procedures: laparoscopic total hysterectomy (LH) in 5 cases, myomectomy in 8 cases, ovarian cyst removal in 5 cases, salpingo-oophorectomy in 3 cases, and pelvic adhesion release in all patients. As seen intraoperatively, the posterior wall of the uterus was adherent to the intestines and the uterorectal fossa was completely closed in 15 cases, the lower part of the uterus was adherent to the bladder in 2 cases, and both the anterior and posterior walls of the uterus were heavily adherent in 2 cases. There were 3 cases of ovarian ovarian cysts with adhesions to the posterior lobe of the broad ligament, greater omentum, and intestinal tubes, and 1 case of adhesion below a previous surgical incision.