Laparoscopic surgery, as an important part of endoscopic surgery, has become a pioneer of the surgical revolution, combining the most advanced modern science and technology with modern medicine, a product of combining traditional surgical techniques with modern electronic information technology, light-guided process technology’s and various energy conduction. It is an extension of the doctor’s vision and arm, which has changed the doctor’s conception of thinking, technical route and operating skills, and is gradually becoming a new model for many gynecological surgical treatments. The use of laparoscopic surgery is widespread and the technology is developing rapidly. It has even been predicted that after the first quarter of the twenty-first century has passed, the vast majority of gynecologic procedures can be performed endoscopically. Without commenting on the realizability of this prediction, there is no doubt about the trend. Admittedly, this surgical revolution will also bring new problems and, as we often say, opportunities and challenges. I. The rapid development of laparoscopic surgery for minimally invasive surgery 1, from 1947 Palmer first laparoscopic application in gynecology, so far only more than half a century, but laparoscopic examination and surgery has been one of the most routine operating techniques in gynecology. This can be divided into the following important milestones: from the 1950s to the 1970s, it was mainly used for examination and simple surgical operations, such as tubal sterilization (electrocoagulation ring clamping) and ovum extraction, etc. The 1970s was a leap forward, one is the expansion of the indications for surgery, such as ovarian cysts, ectopic pregnancy, pelvic inflammatory disease, endoheterosis, etc.; the second is the publication of monographs; the third is the establishment of the American Association of Laparoscopists (AAGL) and academic conferences were held. In 1989, Reich’s first laparoscopic hysterectomy and Querlen’s lymphatic drainage brought gynecological laparoscopic surgery to a new level, which led to the rapid development of the last decade and Semm’s boast that “there is no surgery that cannot be done laparoscopically! “. . Nowadays, laparoscopic surgery has shown its advantages in the following aspects and has been confirmed and widely used: 1. Gynecological emergencies: timely diagnosis and treatment are possible, such as ectopic pregnancy, corpus luteum rupture, acute pelvic inflammation and pelvic abscess, and ovarian cyst torsion. Early ectopic pregnancies can usually preserve the fallopian tubes; ruptured, shocked ectopic pregnancies can be accomplished with rapid operations. We can even say that the implementation rate of laparoscopic surgery for gynecologic emergencies is one of the indicators of the degree of laparoscopic surgery performed in a unit, because it marks the basic concept of laparoscopic surgery and is an indication of the scale of its popularity (there is a significant majority of operable people to be competent for emergencies in all time periods). 2. Benign gynecological tumors: mainly simple cysts of the ovary, benign mature teratomas, ovarian coronary cysts, etc. Laparoscopic surgery should be the preferred method, and some hospitals can perform up to 90% or 100% of laparoscopic surgery for such tumors. 3, endometriosis: laparoscopy is the gold standard for endometriosis diagnosis, the basis for rAFS staging and the best treatment route. Both abdominal and ovarian types can be treated by laparoscopic surgery to achieve lesion reduction, pain relief, fertility improvement and recurrence reduction. In vaginal-rectal endometriosis, laparoscopic surgery, although it can be difficult, can be used in combination with vaginal surgery to increase its safety. Importantly, we do not advocate observational and experimental treatment of suspected endoheterosis or adnexal masses, as it may delay the disease (e.g. ovarian cancer), especially in those with high serum CA125 levels (>200 iu/ml) or imaging suggestive of special 4. Chronic pelvic pain (CPP): this is a common symptom caused by a variety of reasons. Laparoscopy is the best way to make a clear diagnosis, and 80% of CPP can be relieved by microscopic treatment (e.g. separation of adhesions, removal of lesions). For CPP caused by EM, uterosacral nerve transection (LUNA) or presacral neurectomy (LPSN) can also be done microscopically to achieve a remission rate of more than 70%. 5, pelvic inflammatory disease (PID): PID used to be a relative contraindication to laparoscopy 20 years ago, but nowadays it is believed that laparoscopy can be performed for either acute or chronic PID to stop the progression of inflammation, prevent sepsis and shock, reduce pelvic adhesions and CPP, and infertility. In the case of pelvic abscesses, incomplete drainage will delay the disease for a long time, and microscopic incision and drainage or adnexal resection will improve the treatment process and outcome.