1.Surgical indications: Patients with uterine fibroids should be considered for surgical treatment if they have the following conditions Uterus enlarges more than 2.5 months of pregnancy, single fibroid diameter exceeds 5cm Symptoms are obvious, such as excessive menstruation, pelvic occupying pressure (back pain, urinary frequency and urgency, constipation), etc. Uterine fibroids grow rapidly within a short period of time and have the tendency of malignant transformation Uterine fibroids do not shrink but grow during menopause and menopause Uterine fibroids lead to infertility 2, surgical methods: Uterine fibroids mainly have the following surgical treatment methods (1) According to the classification of surgical route Cesarean surgery: Cesarean surgery is a traditional surgical method, which is used by most physicians in medical units, generally a longitudinal incision of about 10cm in length is made in the lower abdomen to complete the surgery, some physicians also use a transverse incision in the lower abdomen, the incision scar is more beautiful, but the surgical field of view is more limited, so for some difficult fibroids should be cautious. Transvaginal surgery: This is also a traditional surgical procedure, which is more suitable for menstruating mothers with vaginal laxity, especially for patients with uterine prolapse, but the surgical field of view is limited and not suitable for patients with large fibroids. The advantage of this procedure is that it does not leave a scar on the abdomen. Laparoscopic surgery: This is a new technique developed and applied in recent years, which is now popular in some hospitals and can be performed smoothly for hysterectomy and myomectomy. The Department of Obstetrics and Gynecology of Shanghai Yangpu District Central Hospital is a key specialty in Shanghai featuring minimally invasive gynecological techniques. The application of laparoscopic techniques is very popular and mature, and currently more than 80% of patients with uterine fibroids are operated laparoscopically. This surgery has the characteristics of less trauma and quick recovery, and is being gradually promoted and popularized in hospitals around the world. Hysteroscopic surgery: The surgery is performed through the natural vaginal and cervical access of human body, the biggest advantage is that there is no surgical incision, but the surgical field of view is limited to the uterine cavity, so this surgery is only suitable for submucosal myomectomy. It is not suitable for other parts of fibroids. (2) Classification according to the scope of surgery Hysterectomy: There are two types of hysterectomy surgery, namely total hysterectomy and subtotal hysterectomy, the difference between the two is that the former removes the uterus and cervix, and the latter nearly removes the uterine body to keep the cervical part. It can be done by cesarean or laparoscopic surgery. Myomectomy: This is an operation to remove fibroids and preserve the uterus, also known as myomectomy or myomectomy. It can be done by cesarean or laparoscopic surgery, and in recent years, myomectomy has also been done by transvaginal route. (3) Laparoscopic uterine artery block + myomectomy. The Department of Obstetrics and Gynecology of Yangpu District Central Hospital has carried out clinical development of this technique since 2000, and has performed thousands of surgeries with good clinical results. In addition, we have conducted extensive basic research on the therapeutic principles of this technique and proposed the single organ (uterus) shock hypothesis for the first time in the international arena, and verified the correctness and theoretical value of this hypothesis, providing a new theoretical basis for the popular clinical application of this technique. The main advantages of this technique: minimally invasive surgery, preservation of the uterus, and low recurrence rate of postoperative fibroids, thus enabling high-quality preservation of the uterus in patients with excessive fibroids. At present, this technique has passed the achievement appraisal of Shanghai Health Bureau. (4) Other surgical methods Radiological interventional uterine artery embolization: A French physician first introduced the application of this technique for the treatment of uterine fibroids in 1995. The technique is performed through a 2mm diameter puncture device, which is cannulated through the femoral artery to reach the uterine artery, and then PVC pellets of about 1mm in diameter are pushed into the vessel, which obstruct the vessel, causing complete obstruction of the myoma nutrient vessels and ischemic infarction of the myoma to achieve the purpose of treating the uterine fibroids. However, after 10 years of clinical exploratory application, it was found that there are some shortcomings and limitations of this technology, and it is rarely used in recent years. Radiofrequency ablation (self-coagulation knife), ultrasound focusing (HAIFU knife). These technologies are similar in treatment principle. The treatment purpose is achieved through energy conversion, that is, the energy of radiofrequency, microwave and ultrasound is converted into thermal energy, which heats up the myoma tissue and causes its degeneration and necrosis. Improper application often results in “under-treatment” or “over-treatment”. In cases of “under-treatment”, the fibroids grow rapidly after surgery; in cases of “over-treatment”, damage to the pelvic organs such as the bladder and intestines may occur, resulting in serious complications, and may also lead to damage to the endometrium, causing amenorrhea in the patient after surgery. These techniques are currently non-mainstream technologies and should be chosen with caution.