Modern laparoscopic surgical techniques have penetrated into every field of clinical surgery after more than 20 years of development, and years of clinical practice have proved that the difference between laparoscopic and open surgery in terms of efficacy and complication rate mainly lies in the degree of technical mastery, rather than in the laparoscopic technique itself, and some laparoscopic procedures have become the first choice or “gold standard” for the treatment of diseases. The “gold standard” procedure. In terms of abdominal surgery has developed from the initial simple surgery to fully laparoscopic pancreaticoduodenectomy, and with the maturity of the technology and the accumulation of experience, the complications and efficacy are getting closer to those of open surgery, which has reinforced the confidence of laparoscopic surgeons; laparoscopic surgery for the radical treatment of malignant tumors has likewise made breakthroughs after years of controversy, and the corresponding retrospective analysis of large numbers of cases as well as The corresponding retrospective analysis of large number of cases and RCT studies have shown that the efficacy of laparoscopic surgery is not statistically different from that of traditional open surgery. At present, the volume of laparoscopic surgery in abdominal surgery in hospitals where it is well performed domestically and abroad has accounted for more than 50% of the total volume of surgery. All these show that laparoscopic technology has passed through its childhood and adolescence and is moving towards its adolescence and adulthood. Even so, laparoscopic techniques still have a lot of room for development, and new treatment modalities are gradually taking shape under the concept of minimally invasive treatment, and rapidly developing technology, medical equipment and instrumentation improvements are providing the necessary conditions for new treatment modalities. The crossover and combination of endoscopic, interventional and laparoscopic treatment of traditional diseases is an example of a new treatment paradigm that often receives miraculous results. Thus, it makes laparoscopic surgeons, while trying to deepen the application of laparoscopic techniques, to broaden their horizons, keep up with the situation, pay attention to the frontiers of laparoscopic technology development and the progress of its combined application with other therapeutic methods, and develop new areas of clinical application of laparoscopic technology. In December 2008, we had the opportunity to participate in the Second Annual International NOTES Course hosted by Presbyterian Hospital/Weill Cornell Medical College in New York, USA, which brought together top laparoscopic and endoscopic surgeons from Europe, USA, Japan and other countries to give a wonderful presentation on the development of endoscopy, laparoscopy, multi-scope combination, and endoscopic surgery via natural orifice (NOTES), as well as their clinical and research work in this area. Leroy (France) and Curcillo (USA) again presented the “Single Port Access” (SPA, Single Port Access), reported their research and preliminary clinical applications in this area, and looked forward to the promising application of this technique. Dr. Gumbs from USA reported the application of LESS (Laparo-Endoscopic Single Site) technique in cholecystectomy and appendectomy with excellent results. ”Hybrid Approaches” was also one of the main topics of the congress, with Lightdale and Stevens from Columbia University Medical Center, USA, presenting their laparoscopic-assisted EMR (Endoscopic Mucosal Resection) and ESD (Endoscopic Submucosal Dissection) in the treatment of early gastrointestinal tract tumors, which attracted a lot of interest. The most interesting part of the conference was of course the discussion on NOTES (Natural Orifice Transluminal Endoscopic Surgery), where Horgan from UCSD (USA) firstly reported his experience in transvaginal cholecystectomy and appendectomy; then Hungness from Northwestern University (Chicago) presented the research, training and clinical work in transgastric cholecystectomy at their hospital. Finally, Dr. Lee from New York-Presbyterian Hospital reported data from their experimental study of NOTES colonic surgery via various routes, which showed that NOTES colonic surgery is safe and feasible. The conference discussions were lively and the academic atmosphere was extremely strong. The main venue of the conference was the Caspary Auditorium at Rockefeller University Park, and the huge photos of more than 30 Nobel Prize winners of the university hung in the hall made people stand in awe and added to the doctrinal atmosphere of the conference. After the meeting, it was quite impressive that the findings of experimental and clinical studies in Western countries once again illustrated the importance of laparoscopic techniques in the future of clinical surgery and that the clinical applications of laparoscopic techniques are being broadened. Although the application of these techniques is not yet mature, and some are still in the experimental stage; although the clinical application of some techniques may still be affected by cultural, religious, ethical and other factors such as NOTES technology, it is entirely possible that with the change of concept, improvement and maturation of technology, it will become one of the directions of surgical development, so that “new laparoscopic techniques “This is also a new challenge for the “traditional” laparoscopic surgery. For this reason, laparoscopic surgeons in China should have a sense of urgency and should dare to innovate and make bold attempts to avoid lagging behind western countries like the development of “traditional laparoscopic techniques”. It is also a new opportunity for laparoscopic surgeons in China.