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.

Laparoscopic colorectal surgery has been carried out in China for more than 30 years and has experienced a three-stage high-speed development of "exploring and designing,optimising and standardising, perfecting and re-innovating" at the technical level. Based on the support and assistance of laparoscopic technology, colorectal surgery has made rapid progress in sub-microscopic anatomy, surgical procedures, surgical concepts, instruments and equipment. Nowadays, the technology and efficacy of laparoscopic colorectal surgery have gradually reached the ceiling, and in view of the existing pain points and the future direction of development, where will we go? This article summarised the past three decades of experience and consolidate the results to guide the future practice and the way forward.

Laparoscopic colorectal surgery has been carried out in China for more than 30 years and has experienced a three-stage high-speed development of "exploring and designing,optimising and standardising, perfecting and re-innovating" at the technical level. Based on the support and assistance of laparoscopic technology, colorectal surgery has made rapid progress in sub-microscopic anatomy, surgical procedures, surgical concepts, instruments and equipment. Nowadays, the technology and efficacy of laparoscopic colorectal surgery have gradually reached the ceiling, and in view of the existing pain points and the future direction of development, where will we go? This article summarised the past three decades of experience and consolidate the results to guide the future practice and the way forward.

Objective To investigate the application of synchronized immersion course(SIC)in teaching of clinical practice of surgery for eight-year program students.Methods A total of 94 eight-year program students in French class and 4+4 class who received SIC in the study of surgery in Ruijin Clinical School,Shanghai Jiao Tong University from September 2017 to June 2019 were selected as the pilot group.A total of 91 students in English class who were taught in the traditional way in the same period were selected as a horizontal control group.A total of 84 students in French class and 4+4 class who were studying from September 2015 to June 2017 were selected as the longitudinal control group.Teaching satisfaction evaluation,examination results and specialization choice were compared among students in each group to assess teaching effectiveness.Results The total score(3.8±0.3)and satisfaction rate(98.9%)of the questionnaire in the pilot group were better than those in the horizontal control group(3.6±0.4,90.1%)(P=0.001,P=0.008).For the case analysis station in objective structured clinical examination(OSCE),the mean score(86.2±6.9)and pass rate(97.9%)in the pilot group were better than those in the horizontal control group(79.7±11.4,89.0%)(P=0.001,P=0.014),as well as better than those in the longitudinal control group(79.5±13.5,88.1%)(P=0.001,P=0.009).For the history inquiry station,the mean score(86.3±10.7)and pass rate(96.8%)in the pilot group were better than those in the horizontal control group(81.4±11.6,86.8%)(P=0.003,P=0.013).The proportion of students choosing the surgical specialty was higher in the pilot group(55.3%)than in the horizontal control group(46.2%)and the longitudinal control group(44.0%)without statistically significant difference.Conclusions SIC can help eight-year program students strengthen their clinical thinking and practice skills.Meanwhile,SIC can increase students'satisfaction with teaching and their interest in surgery.

After more than thirty years of development, laparoscopic surgery technology has become the main platform for surgery and has been widely applied in various fields of surgery. The safety, feasibility and efficacy of laparoscopic technique have already been confirmed in colorectal surgery. In recent years, with a deeper understanding of concepts such as laparoscopic fascial anatomy, laparoscopic colorectal surgery has made new explorations and advances in surgical approach selection, NOSES, lymph node dissection range, preservation of Denonvillier's fascia, functional protection, lateral lymph node dissection, selection of anal preservation techniques for ultra-low rectal cancer, and totally laparoscopic digestive tract reconstruction. In the field of laparoscopic gastric surgery, evidence-based medical evidence in China has entered a harvest period, moreover, functional preservation surgery, esophageal gastric junction adenocarcinoma, and total laparoscopic anastomosis have also become hot topics in this field with new progress. The medical equipment related to minimally invasive surgery has also been developping in recent years and has played an important role in improving minimally invasive surgery.

After nearly 40 years of development, minimally invasive techniques have been widely applied in curative surgeries for various types of tumors. The safety and efficacy of minimally invasive surgery has being fully validated. With the continuous iteration and updating of medical equipments, the convenience and precision of surgeries have been significantly enhanced, marking the advancement of minimally invasive surgery into a phase of high-level platform. With the rapid development of information technology, we have gradually entered the era of intelligent medicine, where the integration of technologies such as artificial intelligence will inject new vitality into the development of minimally invasive surgery. Combined with the latest research trends, the authors provide an in-depth analysis of how artificial intelligence plays a unique role in key aspects of minimally invasive surgery, including preoperative assessment and planning, intraoperative moni-toring and alerting, and comprehensive postoperative management. Additionally, the authors discuss how to utilize these innovative technologies to further promote reforms in medical education and prospects for the development of telemedicine service. In the era of intelligent medicine, the develop-ment of minimally invasive surgery should adhere to the principle of "bold innovation, cautious practice", guided by the concept of "patient-centeredness". By promoting interdisciplinary collabora-tion between medicine and engineering, accelerating the translation of scientific and technological achievements into clinical practice, we can ensure that minimally invasive surgical techniques better serve the health and well-being of the people.

Objective To explore drug use patterns in treatment of lung cancer based on traditional Chinese medicine inheritance assistance platform.Methods A total of 200 effective prescriptions for the treatment of lung cancer patients in the outpatient department of Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2022 to September 2023 were collected and input into the traditional Chinese medicine inheritance assistance platform to conduct association rules and cluster analysis of drugs.Results A total of 200 effective prescriptions were included,involving 146 traditional Chinese medicines.The medicinal properties were mainly cold,warm and flat,and the medicinal flavours were mainly sweet,bitter and pungent,which mainly belong to lung,spleen,stomach and heart meridian.The most frequently used Chinese medicines were Radix Codonopsis Lanceolatae,Radix et Rhizoma Glycyrrhizae,Radix et Rhizoma Salviae Miltiorrhizae,Rhizoma Pinelliae,Actinidia valvata Dunn,Fritillariae Thunbergii Bulbus,etc.27 groups of core drug combinations were obtained,and 5 new prescriptions were obtained.Conclusion Clinical diagnosis and treatment of lung cancer is closely related to the core pathogenesis of Yin deficiency and stasis toxicity,and at the same time,it takes care of the acquired spleen and stomach,mind-body harmony,reflecting the academic thought of traditional Chinese medicine tumor,which reinforce healthy qi to anti-cancer and the holistic view of traditional Chinese medicine.

The application of minimally invasive surgery has experienced rapid develop-ment for more than 30 years. The continuous development of minimally invasive technology and instru-ments in the fields of energy platform and imaging equipment has promoted the progress of laparos-copic surgery to be more accurate and secure, and the development of laparoscopic surgery itself has also continuously fed back the innovation of technology and instruments. In recent years, the innovative development of minimally invasive technology and instruments has been more closely combined with the current scientific and technological frontier, leading to the innovative achievements in the fields of robotic surgery, screenless surgery, artificial intelligence, electronic instrument, virtualization and so on. In the new era, surgeons should always keep an eye on the forefront of science and technology, the combination of surgery and technology, application of advanced technology to solve the key problems of current surgery, so as to inject new vitality into the next development of minimally invasive surgery.

Scientific and technological innovation is the most important role in driving the development of minimally invasive surgery. After more than 30 years of development, modern mini-mally invasive surgery represented by laparoscopic surgery has gradually matured. Various types of minimally invasive surgeries have been popularized, and the difficulty of surgery has changed from extreme to limit. Surgical equipments and instruments can meet the needs of most clinical operations. The future of minimally invasive surgery has reached a crossroad, and only scientific and technological innovation can promote the development of minimally invasive surgery change lanes and overtake, ushering in new development, new methods, and a new world. For innovation, the most important thing is not knowledge, but vision and ideas. A new technological revolution will inevitably bring about changes in the industry. What changes will be ushered in the operation and treatment of diseases in the future? What will be the breakthrough of minimally invasive surgery? It is worth to wait and see. The authors discuss the development direction of minimally invasive surgery based on the recent application of hot technologies in laparoscopic surgery.