Over the past three decades years, the treatment of gastric cancer has shifted from traditional open surgery to minimally invasive surgery. Cutting-edge technologies such as three-dimensional and 4K ultra-high-definition imaging systems, indocyanine green fluorescence navigation, and robotic surgical systems have been widely used in clinical practice, facilitating precise intraoperative anatomy and lymph node dissection. For early gastric cancer, endoscopic submucosal dissection, as the standard surgical procedure, can improve the 5-year survival rate and reduce the local recurrence rate. For locally advanced gastric cancer, neoadjuvant chemotherapy combined with minimally invasive surgery has increased the R0 resection rate and improved the prognosis of patients. For advanced gastric cancer, conversion therapy combined with minimally invasive surgery has brought hope for extended survival to patients with stage Ⅳ disease, and the application of immune checkpoint inhibitors has further promoted the progress of advanced gastric cancer treatment. With the advancement of technology and the improvement of policies, artificial intelligence and 5G remote surgery have become important directions in the minimally invasive surgical treatment of gastric cancer. In the future, it is necessary to accumulate evidence through multi-center prospective studies, optimize the evaluation of function-preserving surgery, develop cross-platform artificial intelligence tools, conduct cost-benefit analyses, and resolve ethical and legal disputes to promote the development of minimally invasive surgical treatment of gastric cancer towards precision and intelligence, achieving a dual improvement in efficacy and accessibility.

In recent years, surgical research has entered the digital era, and the dissemination of medical knowledge has also begun to confront the challenge posed by we media. When we media first emerged, most doctors in public hospitals, who focused on "medicine, education, and research", held a reserved attitude towards it. However, we media has demonstrated remarkable resilience and has continuously evolved to align with the trend of social development. Faced with the future development direction and the existing sore points, how surgeons comprehend and respond to the surging current of the times is a conundrum before us. In this article, the author has sorted out the rise and development of we media, the status of its application in the medical field, and the predicaments faced by medical we media, and has looked forward to its development to broaden the thinking of surgeons for more comprehensive innovation and development.

Objective To explore the effectiveness of an integrated laparoscopic simulation training course (best essential surgical technique training, BEST) in enhancing laparoscopic peritoneal suturing techniques in surgical residents.Methods As an integrated two-stage program, the BEST course applied basic laparoscopic training system with simple molds in phase Ⅰ training, and then adopted advanced laparoscopic training system, 3D Laparoscope and ex-vivo animal models in phase Ⅱ training. The laparoscopic suturing techniques were practiced in phase Ⅱ training. From August 2021 to July 2024, surgical residents in the second year of the national standardized training program were divided into pilot and control groups based on whether they had undergone the BEST course. Two cases of laparoscopic peritoneal suture were performed by the surgical residents under supervision in the department of gastrointestinal surgery. The operative time, quality of suture, and independent completion rate were compared between the two groups.Results A total of 33 surgical residents (19 in pilot group and 14 in control group) were included in this study, and a total of 66 cases of laparoscopic peritoneal suture were performed (38 in pilot group and 28 in control group). The operative time was significantly shorter in pilot group than that in control group (15.7 min vs. 17.5 min, P=0.025). The quality of suture was significantly better in pilot group compared to control group (P=0.023). In pilot group, all peritoneal sutures were performed by residents independently, whereas in control group, 3 cases (10.7%) were assisted by the supervisor, and the independent completion rate was different significantly (P=0.039).Conclusions The BEST course can help improve surgical residents′ laparoscopic peritoneal suturing techniques and could be promoted in the national standardized training program for surgical residents.

Rectal cancer is a prevalent malignant tumor both in China and worldwide. Despite the availability of numerous sphincter-preserving procedures for low rectal cancer, each with specific indications, advantages, and limitations, no single procedure achieves optimal outcomes in all key domains: anal function preservation, surgical complication reduction, local recurrence rate minimization, and patient quality of life improvement. This article reviewed the evolutionary trajectory of laparoscopic sphincter-preserving surgery for low rectal cancer, while addressing current surgical challenges including prevention and management of anastomotic leakage, strategies for ensuring adequate distal resection margins, and functional outcomes prognosis. Corresponding countermeasures for these critical issues were systematically discussed.

Minimally invasive surgery represented by laparoscopy has been carried out for more than 30 years, and the technological development has tended to be flat. Currently, the techno-logy is still improving and innovating on the platform of laparoscopy, from traditional laparoscopy to reduced port and single port laparoscopy, from transabdominal to natural orifice transluminal tech-niques, from standard definition and high-definition to 3D and 4K ultra high definition fluorescence guided laparoscopy. The booming development of robotic surgery is also based on the platform of laparoscopy. From the perspective of disease treatment, there is no revolutionary change, such as changing the long-term efficacy of tumor treatment. In this era of technological prosperity but uncertainty, the future of minimally invasive surgery may not be a single technological innovation, but the organic integration and common development of multiple technologies. The authors will focus on the advantages and challenges of various minimally invasive technologies, and look forward to the application prospects of artificial intelligence in precision technology and decision-making in minimally invasive surgery, in order to open up new paths for the sustainable development of mini-mally invasive surgery, overcome current confusion, and move towards a more accurate, efficient, and popularized future.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Over the past three decades years, the treatment of gastric cancer has shifted from traditional open surgery to minimally invasive surgery. Cutting-edge technologies such as three-dimensional and 4K ultra-high-definition imaging systems, indocyanine green fluorescence navigation, and robotic surgical systems have been widely used in clinical practice, facilitating precise intraoperative anatomy and lymph node dissection. For early gastric cancer, endoscopic submucosal dissection, as the standard surgical procedure, can improve the 5-year survival rate and reduce the local recurrence rate. For locally advanced gastric cancer, neoadjuvant chemotherapy combined with minimally invasive surgery has increased the R0 resection rate and improved the prognosis of patients. For advanced gastric cancer, conversion therapy combined with minimally invasive surgery has brought hope for extended survival to patients with stage Ⅳ disease, and the application of immune checkpoint inhibitors has further promoted the progress of advanced gastric cancer treatment. With the advancement of technology and the improvement of policies, artificial intelligence and 5G remote surgery have become important directions in the minimally invasive surgical treatment of gastric cancer. In the future, it is necessary to accumulate evidence through multi-center prospective studies, optimize the evaluation of function-preserving surgery, develop cross-platform artificial intelligence tools, conduct cost-benefit analyses, and resolve ethical and legal disputes to promote the development of minimally invasive surgical treatment of gastric cancer towards precision and intelligence, achieving a dual improvement in efficacy and accessibility.

In recent years, surgical research has entered the digital era, and the dissemination of medical knowledge has also begun to confront the challenge posed by we media. When we media first emerged, most doctors in public hospitals, who focused on "medicine, education, and research", held a reserved attitude towards it. However, we media has demonstrated remarkable resilience and has continuously evolved to align with the trend of social development. Faced with the future development direction and the existing sore points, how surgeons comprehend and respond to the surging current of the times is a conundrum before us. In this article, the author has sorted out the rise and development of we media, the status of its application in the medical field, and the predicaments faced by medical we media, and has looked forward to its development to broaden the thinking of surgeons for more comprehensive innovation and development.

Minimally invasive surgery represented by laparoscopy has been carried out for more than 30 years, and the technological development has tended to be flat. Currently, the techno-logy is still improving and innovating on the platform of laparoscopy, from traditional laparoscopy to reduced port and single port laparoscopy, from transabdominal to natural orifice transluminal tech-niques, from standard definition and high-definition to 3D and 4K ultra high definition fluorescence guided laparoscopy. The booming development of robotic surgery is also based on the platform of laparoscopy. From the perspective of disease treatment, there is no revolutionary change, such as changing the long-term efficacy of tumor treatment. In this era of technological prosperity but uncertainty, the future of minimally invasive surgery may not be a single technological innovation, but the organic integration and common development of multiple technologies. The authors will focus on the advantages and challenges of various minimally invasive technologies, and look forward to the application prospects of artificial intelligence in precision technology and decision-making in minimally invasive surgery, in order to open up new paths for the sustainable development of mini-mally invasive surgery, overcome current confusion, and move towards a more accurate, efficient, and popularized future.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.