Minimally invasive surgery is widely used in clinical practice for its advantages such as less trauma, less impact on patients, faster postoperative recovery and smaller surgical scars. Various laparoscopic surgeries for gynecological diseases are also favored by patients and friends. However, any treatment method has its indications, and not all cases are suitable for laparoscopic surgery. Now I would like to talk about my views on the situations I encountered in my clinical work. Laparoscopic surgery is suitable for most benign gynecological masses, but laparoscopy should be chosen with caution for ovarian masses. There is no objection to choosing laparoscopic surgery for those preoperatively diagnosed as benign, such as simple ovarian cysts, chocolate cysts and mature teratomas, but laparoscopic surgery is not suitable for malignant tumors, especially malignant epithelial tumors, which may lead to tumor rupture and improve staging, and may lead to tumor implantation and affect treatment Surgical exploration for staging is important for epithelial malignancies, and laparoscopy is deficient in this regard. Some types of ovaries are resistant to chemotherapy, and early patients have good treatment effect, but as long as there is implantation and metastasis, they are basically incurable, and some of them may lead to serious complications, which affect patients’ quality of life, such as ovarian clear cell carcinoma, ovarian mucinous carcinoma, junctional tumor especially junctional mucinous adenoma, etc. Even benign mucinous tumor forms peritoneal pseudomucinous tumor because of tumor rupture and implantation, and such patients have extensive pelvic and abdominal cavity mucus formation, leading to intestinal obstruction and ineffective to radiotherapy, eventually leading to patients’ death from intestinal obstruction; while patients with early mucinous tumors (stage IA, tumor not ruptured) have good results after surgery. The problem is that it is very difficult to diagnose early stage patients accurately before surgery, and most patients need intraoperative frozen pathology examination to confirm the diagnosis. The author has encountered many cases in which laparoscopic surgery at an outside hospital resulted in tumor rupture, thus completely changing the fate of the patient. In case 1, the patient underwent laparoscopic surgery for a medium-sized mass in the right ovary, and the mass ruptured intraoperatively. After surgery, she came to our hospital for additional surgical resection of the uterus contralateral to the ovary, greater omentum, appendix and thorough exploratory staging, and no residual tumor was found, and postoperative intraperitoneal chemotherapy was given. After 3 years of treatment, the pelvic and abdominal cavity recurred and a large amount of mucus was formed, so the patient was operated again to remove the recurrent tumor, remove the mucus and clean with large amount of glucose water, and given postoperative chemotherapy; about 1 year later, the patient recurred again and developed incomplete intestinal obstruction, and was operated again. The patient came to our hospital again 13 months later due to extensive pelvic and abdominal tumor, abdominal distension and intestinal obstruction, and died of intestinal obstruction due to the difficulty of re-operation. Case 2, the patient was operated outside the hospital for ovarian cyst (non-laparoscopic), “intraoperative ovarian cyst was found to be about 25-30 cm, intraoperative tumor rupture, mucus-like fluid flow, intraoperative frozen pathology and postoperative pathology were benign mucinous cystadenoma”, no treatment was performed after surgery, about 5 years later, the patient was operated again for suspected peritoneal pseudomucinous tumor due to abdominal distension. A large amount of mucus was found in the pelvic and abdominal cavity during the operation, and the abdomen was closed after cleaning the mucus and followed up after the operation. Afterwards, the operation was performed once every 2-3 years to clean the mucus, and the operation became more and more difficult, and now, nearly 10 years after the initial operation, the fifth operation is proposed due to the reappearance of symptoms! The abdomen really needs to be “zipped up”. Case 3, the patient was operated laparoscopically for adnexal mass, the ovarian mass was about 8cm, other abnormalities were not seen, the surgery caused the rupture of the mass, the postoperative pathology was clear cell carcinoma of ovary, after the diagnosis of clear cell by our pathology department, she came to our hospital for additional surgery immediately, a large number of corn-like nodules were found on the surface of rectal concavity and intestinal canal during surgery, thorough staging surgery and nodule biopsy were performed, postoperative pathology: the biopsy nodules were The postoperative pathology: the biopsy nodule was found to be clear cell carcinoma, the rest was negative. Postoperative adjuvant chemotherapy, it is foreseen that the final treatment effect will not be satisfactory ……. The purpose of introducing the above is to show that laparoscopic minimally invasive surgery has many advantages, but it is not suitable for all patients. In hospitals with relatively weak oncology awareness, it is undesirable to emphasize laparoscopic surgery unilaterally to satisfy patients’ minimally invasive or other reasons, and patients’ friends themselves should have a clear consciousness. In the author’s opinion, there should be a comprehensive evaluation of the ovarian mass before deciding on laparoscopic surgery, including 1. imaging to understand the nature of the mass, is it a simple cyst or a cystic solidity? What is the ultrasound echogenicity of the cyst and is it homogeneous? What is the density of the cystic fluid and is it higher than the density of water (can be compared with urine in the bladder)? Is there any separation of the cyst? Are there any papilla-like structures? etc. 2.Tumor marker examination such as CA125, CA199, CEA, AFP, HCG, etc. 3.Adequate and comprehensive physical examination. 4.The patient’s age is also one of the factors to be considered, because older patients have relatively more chances to develop malignant tumors, and of course, there are malignant tumors among younger patients. 5. Patients and doctors should fully communicate to understand the advantages and disadvantages of minimally invasive surgery such as laparoscopy, the possible risks and so on. In conclusion, minimally invasive surgery such as laparoscopic surgery has many advantages, but both doctors and patients should not follow the trend blindly!