Laparoscopic technology has been developed in colorectal surgery in China for 30 years. The key to the success of this technology is standardized technical practice and standardized technical promotion. The incidence of rectal cancer，especially mid and lower rectal cancer，is relatively high in China，and because of the special anatomical position，it is more involved in functional preservation. Therefore，the standardization of laparoscopic surgery is more important for radical resection of rectal cancer. This article elaborates on the standardized development of laparoscopic surgery for rectal cancer in China from the aspects of surgical indications，standardized promotion of technology，systematic training，and further standardization of technological innovation.

Laparoscopic surgery has been widely utilized in the treatment of rectal cancer. Considering the predominance of low and ultra-low rectal cancer in China，the rational selection of surgical approaches to achieve both tumor eradication and functional preservation is a clinically significant issue that warrants in-depth investigation. There is a wide range of laparoscopic techniques available for low rectal cancer，necessitating careful preoperative evaluation and precise determination of indications for neoadjuvant therapy. The fundamental objective should be achieving oncological clearance while ensuring appropriate selection of sphincter-preserving procedures. The choice of surgical approach should be personalized according to individual patient characteristics.

It is controversial to perform mesorectal excision（ME）combined with pelvic lateral lymph node dissection（LPLND）for low rectal cancer，and there are no definite indications for whether to perform prophylactic LPLND as well as therapeutic LPLND after neoadjuvant radiochemotherapy. In addition，intraoperative and postoperative complications of lateral pelvic lymph node dissection should be of concern，especially the occurrence of intraoperative hemorrhage and postoperative genitourinary dysfunction. Therefore，it is important to master the surgical indications for lateral pelvic lymph node dissection in low rectal cancer and to make a surgical strategy to improve the patient's survival and prognosis and to reduce intraoperative and postoperative complications.

Laparoscopic surgery has become the development direction of surgical treatment for gastric cancer in China. A series of high-quality clinical studies have confirmed the safety and effectiveness of laparoscopic surgery in the treatment of early and advanced gastric cancer，and its indications have gradually standardized and reached a consensus. Standardizing the dissections scope of lymph nodes according to the characteristics of lymph node metastasis of gastric cancer in China，selecting the reconstruction method of digestive tract rationally based on various factors，paying attention to the standardized surgical treatment of specimens and gradually standardizing the operation process of new technologies and methods are conducive to accurately judging the patient's condition，improving the patient's prognosis and reducing perioperative complications. It is of far-reaching significance to continuously promote the standardized level of laparoscopic surgery for gastric cancer in China.

Patients with early gastric cancer have low probability of lymph node metastasis and better prognosis，so the aim of treatment is not only limited to the radical resection of tumor，but also to preserve residual gastric function and improve patients’postoperative quality of life as much as possible. With the development of surgery for gastric cancer，laparoscopic function-preserving gastrectomy has been gradually applied to early gastric cancer. It mainly consists of two aspects，namely，the reduction of the range of gastrectomy and the reduction of the extent of lymph node dissection. Combined with domestic and international experiences and guidelines，there has been a certain consensus and standard in laparoscopic function-preserving surgery and lymph node dissection for early gastric cancer，which is also a research hotspot in the field of early gastric cancer. The concept of function-preserving surgery is the direction and trend of early gastric cancer treatment，and we should keep pace with the times to promote the development of standardized，minimally invasive，precise and individualized gastric cancer surgery.

Recently，with the increasing proportion of adenocarcinoma of esophagogastric junction and upper third gastric cancer，and the maturity and wide application of laparoscopic technology，the digestive reconstruction after laparoscopic total gastrectomy has become a technical hotspot and difficulty in gastric cancer surgery. The selection strategy of reconstruction mode is still worth discussing. Based on the available evidence，the reconstruction strategy is suggested as follows. The use of linear stapler for related digestive reconstruction has certain advantages. Posterior disconnection has certain advantages in technical operation，but its indications should be paid attention to. Anteperistalsis and antiperistalsis can be selected according to the surgeon’s habits. Roux-en-Y anastomosis without pouch is the main reconstruction.

Laparoscopic distal gastrectomy is the main surgical method for lower gastric cancer. As an important part of surgery，digestive tract reconstruction directly affects the postoperative quality of life of patients. BillrothⅠanastomosis，BillrothⅡanastomosis，Roux-en-Y anastomosis and their corresponding improved methods，Braun anastomosis and Uncut Roux-en-Y anastomosis，are the main reconstruction methods at present. The BillrothⅠanastomosis was physiologically consistent，but was limited by the size and location of the primary tumor. BillrothⅡanastomosis had no tumor staging requirements and solved the problem of anastomotic tension. After combined Braun anastomosis，the risk of postoperative reflux gastritis was significantly reduced. Roux-en-Y anastomosis completely solved bile reflux gastritis，but the operation was complicated and the intestinal continuity was damaged，which was prone to Roux-en-Y stasis syndrome after surgery. Although Uncut Roux-en-Y anastomosis may cause recanalization of the afferent limb，it is still a relatively ideal reconstruction method.

In recent 10 years，transumbilical single-port laparoscopic technique has been basically active in cholecystectomy，appendectomy and fenestration and drainage of hepatic cysts. However，transumbilical single-port laparoscopic partial splenectomy has rarely been reported at home and abroad. Up to now，our team has completed more than 1 000 cases of various types of single-port laparoscopic surgery，and can skillfully complete complex operations such as laparoscopic partial splenectomy and transumbilical single-port laparoscopic left hemiliver resection without auxiliary pore，which provides enough safety guarantee for the implementation of transumbilical single-port laparoscopic splenectomy. In order to explore a new approach to further reduce abdominal trauma and promote rapid recovery of patients，the team attempted a partial splenectomy with a single port transumbilical laparoscope and performed video recordings. This video shows the procedure of a partial splenectomy without any auxiliary channels and without drainage tube.

The detection rate of benign breast diseases is increasing with the progress of auxiliary examination techniques. Among them，the surgical treatment of benign breast diseases is becoming minimally invasive to further improve the quality of life of patients. Energy ablation is a new minimally invasive treatment with few complications，but it also has some shortcomings such as incomplete ablation. However，with the continuous progress of imaging science，ultrasound-guided ablation technology has gradually matured，showing good therapeutic effects and high postoperative satisfaction. In the long run，energy ablation technology has broad application prospects.

Clinical practice China guidelines on central venous vascular access for breast cancer（2022 edition）was made by the experts of the Chinese Society of Breast Surgery（CSBrS）of the Chinese Medical Association organized. The purpose of the guideline was to standardize application of CVA in the clinical practice of breast cancer patients. There has differences among different CVA when they used for breast cancer patients. We mainly interpret the indications and contraindications of different CVAs，channel selection，prevention and treatment of complications and maintenance of different CVAs in the guidelines.

The Chinese Medical Association's Clinical Practice Guide for Breast Surgery（2022）added a new chapter of clinical practice guideline about postoperative lymphedema of breast cancer. According to the Evidence-Based Medical evidences of diagnosis and treatment of postoperative lymphedema of breast cancer，referring to the GRADE standard and following the principle of clinical diagnosis and treatment accessibility，this guideline present recommendations on the high-risk population，diagnosis，staging，treatment and postoperative rehabilitation of postoperative lymphedema of breast cancer in grades. In this paper，combined with practical clinical experience，the key contents of the guideline are interpreted for the reference of relevant people.

The first choice of treatment for de novo stage Ⅳ breast cancer is systemic therapy based on molecular typing. Thanks to the rapid iteration of new anti-cancer drugs and the popularization of clinical application of genetic testing tools，the survival time and quality of life of patients with de novo stage Ⅳ breast cancer have been greatly improved，and the principles of local surgical treatment have become a hot issue of clinical concern. Based on this，the Chinese Society of Breast Surgery took the lead and conducted a discussion on the key issues in the diagnosis and treatment of de novo stage Ⅳ breast cancer，developed the clinical practice guidelines for diagnosis and treatment of de novo stage Ⅳ breast cancer（2022 edtition）.

With the development of the concept of minimally invasive surgery and the innovation of endoscopic instruments，laparoscopic surgery for pancreatic cancer has continuously made great breakthroughs in China，in which it has achieved similar results in comparison to open surgery in terms of safety and feasibility. However，pancreatic cancer is often accompanied by the infiltration of surrounding tissue and the invasion of peripheral lymph node or blood vessel that significantly increases the difficulty of operation，for which it is still remains controversial in terms of the efficacy of minimally invasive surgery. Therefore，in order to promote the standardization of laparoscopic surgery for pancreatic cancer on the whole，the author put forward some viewpoints from the aspects of selection of operation indication，radical resection of tumor and long-term outcome et al.

Surgical resection is the only potential method to cure pancreatic cancer. In the past 10 years，minimally invasive pancreatic resection（including laparoscopy and robotics）has developed rapidly and made great progress. It has become one of the treatment options of pancreatic cancer in larger pancreatic centers. Although minimally invasive pancreatectomy has shown some advantages in perioperative variables compared with the open approach，there are still controversies on the oncological outcomes. The existing evidence of evidence-based medicine is mainly single center，retrospective research，and most of them enrolled mixed pathological types. Therefore，whether minimally invasive radical resection of pancreatic cancer can bring benefits in oncology efficacy must be answered through high-quality randomized controlled studies. The design and implementation of high-quality clinical research and the strengthening of multi-center cooperation will help to enhance the individualized application of minimally invasive technology in pancreatic cancer resection and enhance China’s international influence in this field.

Pancreatic cancer is a highly malignant tumor of the digestive system. Surgery is the ideal treatment for resectable pancreatic cancer. With advancements in surgical techniques，minimally invasive pancreatic surgery，such as laparoscopic surgery，has been carried out worldwide for nearly 30 years. However，the retroperitoneal location of the pancreas and the complexity of adjacent blood vessels make pancreatic cancer surgery extremely challenging. Clinical studies regarding the safety of laparoscopic pancreatic surgery have been conducted in various populations，with relatively clear conclusions. Precise anatomical dissection of main vessels within the pancreatic surgical field is essential to achieve minimal blood loss during surgery. We reviewed clinical studies of laparoscopic pancreatic surgery to summarize the safety and oncological outcomes of surgical treatments. We also introduce our first-hand experience in vessel management in laparoscopic pancreatic surgery.

In recent years，with the rapid development of metabolic and bariatric surgery in China，more and more hospitals started to establish a metabolic and bariatric surgery team providing treatment to patients，and as a result，the annual number of operations has been increasing sharply. At the same time，it is increasingly important to continuously promote the standardization of clinical practice in this discipline in order to improve clinical quality and outcomes. At this stage，as the fundamental of standardization and continuous quality improvement，systematic training is crucial to the surgeons and case managers who are working in this area. In addition，surgeons need to strictly follow the surgical indications and choose an evidence-based operation to patients. After surgery，long-term follow-up and clinical data management are also important measures to promote the standardization of metabolic and bariatric surgery.

Metabolic and bariatric surgery in China has entered a period of rapid development. In addition to sleeve gastrectomy and Roux-en-Y gastric bypass，there are also a variety of surgical procedures emerging in clinical practice，including one anastomotic gastric bypass，biliopancreatic diversion with duodenal switch，single anastomotic duodenal-ileal bypass with sleeve gastrectomy，duodenojejunal bypass with sleeve gastrectomy，jejunal-jejunal bypass with sleeve gastrectomy，gastrojejunal transit bipartition with sleeve gastrectomy，etc. For surgeons who have not experienced systematic theoretical knowledge and clinical practice training，and who have recently started metabolic and bariatric surgery practice，the choice of surgical procedures often creates confusion. The principle is to identify the surgical methods that are strongly recommended，cautiously recommended，not recommended and investigational. According to surgon’s own capability，team capability，availability of facility and equipment，as well as patients' comorbidities and expectations，the mode of shared decision-making between surgeons and patients should be adopted to objectively select an appropriate surgical procedure.

China has entered a period of rapid development of Bariatric and metabolic surgery. We continue to explore the specialized development of Bariatric and metabolic surgery，standardized surgery training，academic exchanges and scientific research，and more and more voices of Chinese bariatric and metabolic surgery are heard in the international community. How to achieve simultaneous development of quantity and quality is the question that every bariatric and metabolic surgeon should think about.

Standardized clinical data is an important basis for high-quality clinical and fundamental research，a powerful guarantee for improving clinical practice，and a basis for clinical decision-making and medical policy formulation. The construction and management of a standardized clinical database can improve the quality of clinical data. Based on the Greater China Metabolic and Bariatric Surgery Database，this paper focuses on the establishment process and practical experience of the clinical database in five aspects：background and purpose，set-up process，quality improvement issues，clinical data protection，and prospects，in the hope of promoting high-quality clinical research and clinical practice in metabolic and bariatric surgery.