The firstcryosurgery for cancer was performedin 1850 by James Arnott in England. In the past, the only way to apply cryourgery to organ inside the body was to perform the open surgical approach and popularizedby Nikolai Korpan. Improvement of cryo apparatus, introducing the more feiner diameterof the cryo-probes, better imaging system and especially the skill improvement, led to the rapid development of the percutaneous approach in the late of 20thcentury. Laparoscopic procedures have developed revolutionarysince early 1990s. Cuscheri reported in 1995 the first laparoscopic assisted hepatic cryotherapy for liver tumor. To day,three waysare available for erforming cryotherapyfor intra abdominal malignancy: Percutaneous, open and laparoscopic approaches. Open approach is still the regular way for cryoablation of voluminousor complex tumor. Percutaneouscryosurgery is generallyaccepted as therapy of choiceas the most minimally invasiveapproach, but a special skill with long learning curve is required. The rationale of using laparoscopy in cryosurgery due to the advantages of minimallyinvasive surgery technique with excellent tool for diagnostic, and therapy, monitoring the whole process of cryoablation to improve the patient safety in more complicated cases. One of the important advances in laparoscopy is in the area of intra abdominal in malignancy diagnostic, laparoscopy is being increasingly employed for diagnosis and staging of intra abdominal malignancies. This technique may reveal general metastases or secondary nodules in the liver, peritoneum or adenopathy, thus rendering further procedures unnecessary and saving the patient a rather prolonged convalescence or to perform additional surgical procedure simultaneously. In the recent years, more advanced development in laparoscopic techniques has been achieved like 3D and 4k imaging system for better visualisation, application of indocyanine green fluoroscopy, tele surgery and robotic surgery. These will support the further increasing role of laparoscopic approach in cryosurgery for intraabdominal malignancy.

Barlian Sutedja教授丨第二十一届世界冷冻大会发言：题目《腹腔镜方法在腹腔内恶性肿瘤冷冻消融治疗中的作用》

1850年，英国的James Arnott首次对癌症进行了冷冻手术。在过去，对体内器官进行冷冻治疗的唯一方法是进行开放式手术，并由Nikolai Korpan推广。冷冻设备的改进，引进直径更大的冷冻探针，更好的成像系统，特别是技术的提高，导致了20世纪末经皮手术的迅速发展。腹腔镜手术自20世纪90年代初以来有了革命性的发展。Cuscheri在1995年报道了第一例腹腔镜辅助肝脏肿瘤冷冻治疗。今天，有三种方法可用于腹腔内恶性肿瘤的冷冻治疗。经皮、开放和腹腔镜方法。开放式方法仍然是对大量或复杂肿瘤进行冷冻消融的常规方法。经皮冷冻手术作为最微创的方法被普遍接受为首选疗法，但需要有特殊的技能和漫长的学习曲线。在冷冻手术中使用腹腔镜的理由是由于微创手术技术的优势，它是诊断和治疗的优秀工具，监测冷冻消融的整个过程，在更复杂的情况下提高病人的安全性。腹腔镜的重要进展之一是在恶性肿瘤的腹腔内诊断领域，腹腔镜正越来越多地被用于腹腔内恶性肿瘤的诊断和分期。这种技术可以发现肝脏、腹膜或腺病的一般转移或继发性结节，从而使进一步的手术成为不必要的，并使病人节省了相当长的疗养时间或同时进行额外的手术。近年来，腹腔镜技术得到了更多的发展，如3D和4K成像系统，以获得更好的视觉效果，应用吲哚青绿透视，远程手术和机器人手术。这些都将支持腹腔镜方法在腹腔内恶性肿瘤冷冻手术中的作用进一步增加。