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China is seen variously as an ancient civilization extending over a large area in East Asia, a nation and/or a multinational entity. With nearly 4,000 years of continuous history, China is one of the world's oldest civilizations. Prior to the 19th century, it possessed one of the most advanced societies and economies in the world; but through successive dynasties it then missed the industrial revolution and began to decline. In the 19th and 20th century, imperialism, internal weakness and civil wars damaged the country and its economy, and led to the overthrow of imperial rule. In 1949, after major combat ended in the Chinese Civil War, two states calling themselves "China" emerged: The People's Republic of China (PRC), established in 1949, commonly known as China, has control over mainland China and the largely self-governing territories of Hong Kong (since 1997) and Macau (since 1999). The Republic of China (ROC) established in 1912 in mainland China, now commonly known as Taiwan, has control over the islands of Taiwan, Penghu, Kinmen, Matsu, the Pratas island group, and a few other outlying islands.In the 1950s, change to economic policies in Taiwan transformed the island into a technology-oriented industrialized developed economy after a period of high growth rates and rapid industrialization. In mainland China, in the 1970s, reforms known as the Four Modernizations improved agriculture, industry, technology and defense, vastly raising living standards and making the PRC one of the great powers. Laparoscopic surgery in the mainland of China began in 1991, when Dr. XUN Zu-wu from the Second Hospital of Qujing City in Yunnan Province successfully performed the first laparoscopic cholecystectomy. From then on, the implementation of laparoscopic techniques has been increased rapidly all over China. These techniques have been used nearly in all fields of general surgery including colorectal, gastric, hepatic, pancreatic, thyroid and mammary surgeries. Since the end of the last century, laparoscopic surgery has been widely used in oncologic practice, indicating the higher level and newer era of minimally invasive surgery in China. More recently, natural orifice transluminal endoscopic surgery has become the newest technique emerging in the field of surgery. Many Chinese surgeons have been involving in transumbilical single port surgery and hybrid laparo-endoscopic surgery. Here, we review the history and present status of laparoscopic surgery in the mainland of China.
