# Application of Laparoscopy in Comprehensive Staging Operation of Ovarian Cancer Based on Electronic Medical Blockchain Technology

Authors: Limei Zhang; Xinrui Li; Yao Ning; Yufei Cai
Journal: Journal of Healthcare Engineering
 (2021)

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## Abstract

Ovarian cancer has always entangled most women. Studies have shown that the prevalence of ovarian cancer ranks third in female reproductive malignancies, and the mortality rate has always been the highest. The reason is mainly because the diagnosis and treatment of preovarian cancer has always been a big problem. However, the emergence of laparoscopy can well solve this problem, especially laparoscopy assisted by blockchain technology, which plays a huge role in the overall staging of ovarian cancer. This article proposes the application research of laparoscopy in the comprehensive staging of ovarian cancer based on electronic medical blockchain technology. First of all, this article uses the literature method to study the clinical characteristics and surgical classification of ovarian cancer, as well as the application status of blockchain technology and laparoscopic technology. Secondly, it designed an application experiment based on electronic medical blockchain technology to assist laparoscopy in the comprehensive staging of ovarian cancer and analyzed the comparison of the laparoscopic group and the control group in the comprehensive staging of ovarian cancer. The results of the study showed that the amount of bleeding in the laparoscopic group was 103.5 ml, while the amount of bleeding in the control group was 141.1 ml; the proportion of tertiary pain in the laparoscopic group was 11.37%, and the proportion of tertiary pain in the control group was 31.82%. From this, it can be seen that, in the comprehensive staging operation for ovarian cancer, the laparoscopic group has less intraoperative blood loss than the control group and lower pain, and the treatment effect is better.


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## Body

## 1. Introduction

With the development of science and technology and the continuous improvement of people’s attention to physical and mental health, the detection rate of early ovarian cancer patients has increased significantly [1]. It provides better treatment opportunities, improves the quality of life of patients, increases the survival rate of patients, and provides good living conditions. The treatment of early ovarian cancer is mainly carried out through surgery. Through the development of laparoscopic technology, more and more gynecological oncologists have also begun to apply laparoscopic technology to the treatment of ovarian cancer and found that they can reduce surgical trauma while treating diseases.Laparoscopy is now widely used in the diagnosis and treatment of early cervical cancer, uterine sarcoma, and endometrial cancer. However, if laparoscopy can be applied to patients with malignant ovarian tumors, there is still great uncertainty. However, laparoscopic surgery technique of ovarian cancer can have a broad perspective, the organizational structure and less blood loss surgery is an enlarged clear advantage. In addition, it is very convenient to comprehensively explore the pelvic organs and tumor metastasis [2]. In addition, laparoscopic surgery supported by electronic medical blockchain technology can completely eliminate the retroperitoneal lymph nodes during the operation. Therefore, most gynecology departments are widely used to treat malignant tumors. In addition, the application of laparoscopy can be combined with surgery and biopsy of ovarian tumors to quickly confirm the diagnosis. Laparoscopy technology provides a new method for early diagnosis and surgical treatment of ovarian cancer.Hirabayashi et al.’s single-port laparoscopic surgery is developing rapidly worldwide and is expected to replace traditional laparoscopic surgery. The objective is to evaluate the safety, advantages, and disadvantages of single-port laparoscopic surgery through summing up experience. The design is a retrospective review of the surgical procedures and results of 288 consecutive single-port laparoscopic colorectal cancer surgeries from September 2009 to March 2015. The main results are to describe and analyze the patient’s background characteristics (age, gender, and tumor location), surgical details (type, duration, intraoperative blood loss, intraoperative complications, and conversion to open surgery), and postoperative follow-up (complications within 30 days). Results are 36 cases of ileectomy, 54 cases of right hemicolectomy, 21 cases of transverse colon, 25 cases of left hemicolon, 33 cases of sigmoid colon, 68 cases of high anterior resection, 24 cases of low anterior resection, and 24 cases of abdominal perineal resection. However, this experiment did not fully explain the application process of laparoscopic surgery, and the description is not complete [3]. Ohtani et al. conducted a meta-analysis of the short-term and long-term effects of robot-assisted (RAS) and traditional laparoscopic surgery (LAS) in the treatment of rectal cancer [4]. Materials and methods: they used specific search terms to retrieve related papers published by MEDLINE from 2010 to December 2017. They analyzed the short-term and long-term results. Results: they identified 23 papers that reported comparing the results of RAS and LAS for rectal cancer. Their meta-analysis included 4348 patients with rectal cancer: 2068 received RAS and 2280 received LAS. During the short-term and long-term periods, 27 and 7 outcome variables were examined, respectively. In long-term rectal cancer surgery, compared with open surgery, the results of short-term surgery and the incidence of rectal cancer are significantly reduced. Conclusion: compared with LAS, RAS is an acceptable surgical treatment for rectal cancer. However, he did not explain the advantages and disadvantages of laparoscopic surgery in medicine [5]. Lemieux aims to explore the value of blockchain technology as a solution to create and preserve trusted digital records and introduce some of the limitations, risks and opportunities of this method. The methodological approach involves the use of requirements in record management and digital preservation standards, in particular ISO 15489, ARMA’s recognized record preservation principles, ISO 14721 and ISO 16363, as a risk-based assessment framework for the blockchain of land registration systems in developing countries The specific implementation of technology conducts risk assessment. Research results: the analysis results show that, assuming appropriate security architecture and infrastructure management control [6], blockchain technology can be used to solve current and recent issues related to information integrity. However, it cannot guarantee the reliability of information at first, and as a long-term solution to provide credibility, it has some limitations [7].The innovations of this article are the following: (1) it combines qualitative research and quantitative research, as can be seen from the fourth part of this article; (2) it combines theoretical research and empirical research; this innovation runs through the whole text. In terms of the technology itself, it is analyzed in combination with the clinical application of ovarian cancer surgery, so as to fully explain the advantages of laparoscopy. (3) Make full use of high-tech computer technology—the combination of blockchain technology and medical technical research to promote the development and innovation of the medical field.


## 2. Application Method Based on Electronic Medical Blockchain Technology to Assist Laparoscopy in the Comprehensive Staging of Ovarian Cancer

### 2.1. Ovarian Cancer Symptoms and Surgical Classification

Ovarian malignant tumor is one of the common malignant tumors of female reproductive organs, and it is the most frequent disease after cervical cancer and uterine body cancer [8]. Epithelial cancer is the most common malignant tumor of the ovary, followed by malignant germ cell tumors. Among them, the death rate of epithelial ovarian cancer is the first among all kinds of gynecological tumors [9], which poses a serious threat to women’s lives. The ovaries are located deep in the pelvic cavity. They are small in size and have no typical symptoms. Early detection is difficult. In patients with epithelial ovarian cancer, less than 30% of the tumors are confined to the ovaries, and most of them have spread to the pelvis and abdomen. Early diagnosis has become a major issue [10].Clinical manifestations of ovarian cancer: (1) epithelial ovarian cancer usually has no obvious symptoms in the initial stage. Approximately 70% of patients are already in the advanced stage. The general symptoms of the initial patients are as follows: abdomen size, mainly due to the enlargement of the mass or the combination of abdominal and pelvic fluid. Abdominal pain: ovarian tumors may cause a certain degree of abdominal pain due to changes in tumors such as bleeding, necrosis, and rapid growth. Weight loss: loss of appetite due to illness may be accompanied by weight loss [11, 12]. (2) The symptoms of ovarian cell malignant tumors are different from those of epithelial cancer. Abdominal swelling lump, in most cases, is due to hemorrhage and necrosis, infection, or tumor rupture inside the vagina, resulting in acute abdominal symptoms occurring at an early stage. Among them, 60% to 70% of patients are in the initial stage [13, 14].Surgical classification of early ovarian cancer is as follows.


#### 2.1.1. Comprehensive Staging Surgery

Surgery should be the first choice for early ovarian cancer. The purpose of surgery is not only to remove the tumor, but more importantly, to make a clear diagnosis and obtain a complete pathological stage classification [15]. Currently, this operation is often referred to as a full staging phase. The contents of the operation usually include cleaning of the abdomen after entering the abdomen, extensive investigation and biopsy of body fluids or ascites and suspicious parts of the peritoneum, regular hysterectomy, bilateral adnexectomy, mastectomy (usually along the large intestine base), and swelling of pelvic lymph nodes and aortic lymph nodes. The NCCN guidelines emphasize that the lymph nodes around the aorta need to be at least in the lower part of the medial artery and, if possible, need to be removed at the level of the renal blood vessels [16]. If it is epithelial cancer, the appendages need to be removed regularly [17]. In patients with early ovarian cancer, if the lymph nodes are not eliminated, it is impossible to determine whether there is lymph node metastasis. In other words, it is impossible to achieve a correct and comprehensive classification of the disease stage, which has a negative impact on postoperative treatment and prognosis. Therefore, it was concluded that the earlier the cancer, the more comprehensive the examination that should be carried out.


#### 2.1.2. Restaging Surgery

Restaging surgery refers to patients who have not undergone the first surgery, before starting chemotherapy, in order to achieve the goal of complete disease classification and complete staged surgery again [18]. What is needed is to avoid unnecessary chemotherapy for actual early patients, find possible late patients, and avoid inappropriate treatment.


#### 2.1.3. Staging Surgery to Preserve Fertility

In patients with epithelial ovarian cancer, most of the opposite ovaries have recessive metastases, which require careful selection. In the case of border tumors, most of them are in the early stage, with a long survival period and slow recovery, so surgery to maintain fertility can usually be performed [17]. Surgery to maintain fertility is safe for patients with borderline ovarian cancer. It is recommended to confirm pregnancy as soon as possible after surgery. It is recommended to confirm the pregnancy as soon as possible after the operation. After giving birth, a second uterus and fertility preservation operation must be performed according to the situation [19].The above operations can be done under laparoscopy, but two most basic conditions are required: one is to completely remove the tumor without affecting the staging, to avoid the tumor from rupturing during the operation or during removal, which may cause pelvic and abdominal dissemination; the other is that the surgeon should have a more skilled laparoscopic paraaortic lymph node resection technique and at least reach the level of the inferior mesenteric artery [20].


### 2.2. Laparoscopic Surgery Assisted by Electronic Medical Blockchain Technology

Laparoscopy is similar to electronic gastroscope. It is a medical device with a miniature camera. Its basic structure is shown in Figure1. The main five basic systems are the video surveillance system in the laparoscope, CO2 gas abdominal system, electric cutting system, flushing-suction system, and surgical instruments [21, 22]. Among them, this monitoring system mainly includes a laparoscope, a microhole camera, a video recorder, and light source equipment required for video recording. In surgery, a fixed angle and light source intensity are generally used. All electronic products are 2.5–10 mm in diameter. The CO2 pneumoperitoneum system is mainly to provide a suitable space and pressure for the operation. It controls the air pressure in the cavity between 12 and 15 mmHg through the use of a spring insufflator needle, an insufflator, and a carbon dioxide cylinder. The flushing system is to clean the cavity, provide a clear perspective to the doctor, and prevent adhesion. The absorption system mainly uses the duct effect to attract. Surgical instruments include many basic surgical instruments, including scissors, trocars, and graspers [23, 24].Figure 1
Basic system composition of laparoscopy.The clinical application of laparoscopic surgery can be used for general surgery, urological surgery, obstetrics and gynecology surgery, and thoracic surgery, including uterine fibroids, total hysterectomy, and ovarian cancer [25]. In addition, it can also be used for diagnosis of lymphatic biopsy, diagnosis of chronic abdominal pain, diagnosis of liver disease, ascites, etc.The advantages of using laparoscopic technology for ovarian cancer surgery are as following: first, the laparoscopic microporous video camera can provide a full range of perspective, and it is clear enough to provide doctors with a good operating environment [26]; second, the use of laparoscopic surgery has smaller wounds than open surgery, so the recovery speed is faster, and the incidence of complications and sequelae is low; third, the use of general anesthesia for laparoscopic technology can further enhance the safety of the operation, and the laparotomy can be replaced according to the progress of the operation [27].At present, the application of laparoscopic technology in the diagnosis and treatment of ovarian cancer is mainly limited to the early clinical stage classification of ovarian cancer and the diagnosis and differential diagnosis of additional stage classification, posttreatment evaluation, and early diagnosis of recurrence [28]. Considering the academic nature, clinical anatomy, and biological diagnosis of ovarian cancer, the clinical application of laparoscopic surgery for advanced ovarian cancer is limited, and there are still many contradictions. Figure 1 is a structural diagram of the basic system of laparoscopy.


### 2.3. Blockchain Technology

Blockchain is a new method of applying decentralized data storage, point-to-point transmission, computer technology [29], consensus mechanism, and encryption algorithm. Blockchain is an important concept of Bitcoin. This is basically a decentralized database. At the same time, like the basic technology of Bitcoin, it is a series of data blocks made using encryption. The data block contains a large amount of Bitcoin transaction information. This is used to verify the validity of the information (to prevent forgery) and create the next information block.Blockchain technology supports the application of laparoscopic technology in the classification of ovarian cancer syndromes. Combining the latest methods of modern medical technology and computer technology, three-dimensional model data about various organs of the human body can be collected through the computer to establish the function of three-dimensional mirroring [30]. This technology can simulate traditional medical endoscopes for endoscopic examination of patients. This is a new way to help diagnose diseases. Because it is a noncontact test tool, it can reduce the patient's pain and reduce the risk of bleeding and infection.Blockchain mainly has the following key characteristics: (1) decentralization: through the use of blockchain technology, there is no need to design a dedicated data center for the hospital [31], and each department only needs to use a consensus algorithm to realize the synchronous update and modification of data; (2) persistence: valid data is added to the blockchain and it is almost impossible to delete or modify; (3) anonymity: each user interacts by hiding his true identity information; (4) auditability: the information in the blockchain is easy to verify or track transaction records.Representative devices of virtual reality technology are removable display screens, data gloves, TELTACT gloves, data suits, etc. The data glove is an input device that converts human hand movements into computer input signals and detects hand movements by connecting position and direction sensors and cables, with optical fibers. It can be applied to ovarian cancer surgery using laparoscopy, and it plays a very important role in minimally invasive surgery.The basic data layer in the blockchain includes hash functions, Merkle trees, encryption algorithms, and time stamps.(1)
Merkle tree: Merkle tree is a kind of data structure. It is very important in the block chain; the main function is to realize the integration of data, so as to obtain the summary information of the transaction data in the block. For the binary tree structure, assuming that the total number of nodes isN, the depth of the tree is depth, and n is the number of leaf nodes; then (1)N≥n+n2+n4+⋯+1=2n−1,(2)log2n+1≤depth≤log2n+2,(3)depth=log2n+1.It can be seen from the above formula that, under the binary tree structure, the total number of nodes and the tree height depth both show linear growth as the number of leaf nodesn increases. Then, for a Merkle tree generated from n data files in blocks, there are the following relations:(4)2m2d−2×m2≤n≤md−1×m.Furthermore, the depth of the multifork Merkle tree is(5)logmn≤depth≤logm/2n2+1.Data integrity verification process:Setup stage: This stage is also called the initialization stage. It mainly constructs the public and private parameters required by the verification process, processes the data file into blocks, and generates the corresponding homomorphic label set and the corresponding multifork Merkle tree structure.(1)
Generate a public-private keypk,sk pair on the client, randomly select the private keyα←Zp, and calculate the corresponding public key v=ga, that is, private key sk=α, public key pk=v.(2)
Perform block processing on the data file to generate a homomorphic label setF=f1,f2,⋯,fn, that isTagBlocksk,F⟶Φ, and use the formula(6)σi=Hfi•ufix|σi∈G,i=1,2,⋯,n.Generate homomorphic labels for each data block, and then form a set of homomorphic labelsΦ=σi1≤i≤n.Challenge stage: At this stage, the client initiates an integrity verification request to the cloud server. (1) Select a random item from the index set [1,n] of the data file management, select the random s1,s2,⋯,slnumber vi of each si, combine the two generation request challenges chal=si,vi1≤i≤l, and send them to the server to start the verification process. (2) The server generates evidence after receiving the verification request, that is, GenProofpk,Φ,chal⟶P, using the data file F, the homomorphic tag set Φ, the client public key pk = (v), and the received challenge chal to construct the integrity of the data file by the following formula:Generate homomorphic labels for each data blockσi, and then form a set of homomorphic labels Φ=σi1≤i≤n.(7)σ=∏i=s1slσivi=∑i=s1slHviviuvisi,μ=∑i=s1slvifi.If the evidence is availableP=σ,μ, the evidence P is sent to the client.(2)
After receiving the evidence, the client executes an algorithmCheckProofpk,chal,P⟶T,F to verify whether the evidence is true; that is, check the equation(8)eσ,g=?e∏i=s1slHvivi⋅uμ,v.


## 2.1. Ovarian Cancer Symptoms and Surgical Classification

Ovarian malignant tumor is one of the common malignant tumors of female reproductive organs, and it is the most frequent disease after cervical cancer and uterine body cancer [8]. Epithelial cancer is the most common malignant tumor of the ovary, followed by malignant germ cell tumors. Among them, the death rate of epithelial ovarian cancer is the first among all kinds of gynecological tumors [9], which poses a serious threat to women’s lives. The ovaries are located deep in the pelvic cavity. They are small in size and have no typical symptoms. Early detection is difficult. In patients with epithelial ovarian cancer, less than 30% of the tumors are confined to the ovaries, and most of them have spread to the pelvis and abdomen. Early diagnosis has become a major issue [10].Clinical manifestations of ovarian cancer: (1) epithelial ovarian cancer usually has no obvious symptoms in the initial stage. Approximately 70% of patients are already in the advanced stage. The general symptoms of the initial patients are as follows: abdomen size, mainly due to the enlargement of the mass or the combination of abdominal and pelvic fluid. Abdominal pain: ovarian tumors may cause a certain degree of abdominal pain due to changes in tumors such as bleeding, necrosis, and rapid growth. Weight loss: loss of appetite due to illness may be accompanied by weight loss [11, 12]. (2) The symptoms of ovarian cell malignant tumors are different from those of epithelial cancer. Abdominal swelling lump, in most cases, is due to hemorrhage and necrosis, infection, or tumor rupture inside the vagina, resulting in acute abdominal symptoms occurring at an early stage. Among them, 60% to 70% of patients are in the initial stage [13, 14].Surgical classification of early ovarian cancer is as follows.


### 2.1.1. Comprehensive Staging Surgery

Surgery should be the first choice for early ovarian cancer. The purpose of surgery is not only to remove the tumor, but more importantly, to make a clear diagnosis and obtain a complete pathological stage classification [15]. Currently, this operation is often referred to as a full staging phase. The contents of the operation usually include cleaning of the abdomen after entering the abdomen, extensive investigation and biopsy of body fluids or ascites and suspicious parts of the peritoneum, regular hysterectomy, bilateral adnexectomy, mastectomy (usually along the large intestine base), and swelling of pelvic lymph nodes and aortic lymph nodes. The NCCN guidelines emphasize that the lymph nodes around the aorta need to be at least in the lower part of the medial artery and, if possible, need to be removed at the level of the renal blood vessels [16]. If it is epithelial cancer, the appendages need to be removed regularly [17]. In patients with early ovarian cancer, if the lymph nodes are not eliminated, it is impossible to determine whether there is lymph node metastasis. In other words, it is impossible to achieve a correct and comprehensive classification of the disease stage, which has a negative impact on postoperative treatment and prognosis. Therefore, it was concluded that the earlier the cancer, the more comprehensive the examination that should be carried out.


### 2.1.2. Restaging Surgery

Restaging surgery refers to patients who have not undergone the first surgery, before starting chemotherapy, in order to achieve the goal of complete disease classification and complete staged surgery again [18]. What is needed is to avoid unnecessary chemotherapy for actual early patients, find possible late patients, and avoid inappropriate treatment.


### 2.1.3. Staging Surgery to Preserve Fertility

In patients with epithelial ovarian cancer, most of the opposite ovaries have recessive metastases, which require careful selection. In the case of border tumors, most of them are in the early stage, with a long survival period and slow recovery, so surgery to maintain fertility can usually be performed [17]. Surgery to maintain fertility is safe for patients with borderline ovarian cancer. It is recommended to confirm pregnancy as soon as possible after surgery. It is recommended to confirm the pregnancy as soon as possible after the operation. After giving birth, a second uterus and fertility preservation operation must be performed according to the situation [19].The above operations can be done under laparoscopy, but two most basic conditions are required: one is to completely remove the tumor without affecting the staging, to avoid the tumor from rupturing during the operation or during removal, which may cause pelvic and abdominal dissemination; the other is that the surgeon should have a more skilled laparoscopic paraaortic lymph node resection technique and at least reach the level of the inferior mesenteric artery [20].


## 2.1.1. Comprehensive Staging Surgery

Surgery should be the first choice for early ovarian cancer. The purpose of surgery is not only to remove the tumor, but more importantly, to make a clear diagnosis and obtain a complete pathological stage classification [15]. Currently, this operation is often referred to as a full staging phase. The contents of the operation usually include cleaning of the abdomen after entering the abdomen, extensive investigation and biopsy of body fluids or ascites and suspicious parts of the peritoneum, regular hysterectomy, bilateral adnexectomy, mastectomy (usually along the large intestine base), and swelling of pelvic lymph nodes and aortic lymph nodes. The NCCN guidelines emphasize that the lymph nodes around the aorta need to be at least in the lower part of the medial artery and, if possible, need to be removed at the level of the renal blood vessels [16]. If it is epithelial cancer, the appendages need to be removed regularly [17]. In patients with early ovarian cancer, if the lymph nodes are not eliminated, it is impossible to determine whether there is lymph node metastasis. In other words, it is impossible to achieve a correct and comprehensive classification of the disease stage, which has a negative impact on postoperative treatment and prognosis. Therefore, it was concluded that the earlier the cancer, the more comprehensive the examination that should be carried out.


## 2.1.2. Restaging Surgery

Restaging surgery refers to patients who have not undergone the first surgery, before starting chemotherapy, in order to achieve the goal of complete disease classification and complete staged surgery again [18]. What is needed is to avoid unnecessary chemotherapy for actual early patients, find possible late patients, and avoid inappropriate treatment.


## 2.1.3. Staging Surgery to Preserve Fertility

In patients with epithelial ovarian cancer, most of the opposite ovaries have recessive metastases, which require careful selection. In the case of border tumors, most of them are in the early stage, with a long survival period and slow recovery, so surgery to maintain fertility can usually be performed [17]. Surgery to maintain fertility is safe for patients with borderline ovarian cancer. It is recommended to confirm pregnancy as soon as possible after surgery. It is recommended to confirm the pregnancy as soon as possible after the operation. After giving birth, a second uterus and fertility preservation operation must be performed according to the situation [19].The above operations can be done under laparoscopy, but two most basic conditions are required: one is to completely remove the tumor without affecting the staging, to avoid the tumor from rupturing during the operation or during removal, which may cause pelvic and abdominal dissemination; the other is that the surgeon should have a more skilled laparoscopic paraaortic lymph node resection technique and at least reach the level of the inferior mesenteric artery [20].


## 2.2. Laparoscopic Surgery Assisted by Electronic Medical Blockchain Technology

Laparoscopy is similar to electronic gastroscope. It is a medical device with a miniature camera. Its basic structure is shown in Figure1. The main five basic systems are the video surveillance system in the laparoscope, CO2 gas abdominal system, electric cutting system, flushing-suction system, and surgical instruments [21, 22]. Among them, this monitoring system mainly includes a laparoscope, a microhole camera, a video recorder, and light source equipment required for video recording. In surgery, a fixed angle and light source intensity are generally used. All electronic products are 2.5–10 mm in diameter. The CO2 pneumoperitoneum system is mainly to provide a suitable space and pressure for the operation. It controls the air pressure in the cavity between 12 and 15 mmHg through the use of a spring insufflator needle, an insufflator, and a carbon dioxide cylinder. The flushing system is to clean the cavity, provide a clear perspective to the doctor, and prevent adhesion. The absorption system mainly uses the duct effect to attract. Surgical instruments include many basic surgical instruments, including scissors, trocars, and graspers [23, 24].Figure 1
Basic system composition of laparoscopy.The clinical application of laparoscopic surgery can be used for general surgery, urological surgery, obstetrics and gynecology surgery, and thoracic surgery, including uterine fibroids, total hysterectomy, and ovarian cancer [25]. In addition, it can also be used for diagnosis of lymphatic biopsy, diagnosis of chronic abdominal pain, diagnosis of liver disease, ascites, etc.The advantages of using laparoscopic technology for ovarian cancer surgery are as following: first, the laparoscopic microporous video camera can provide a full range of perspective, and it is clear enough to provide doctors with a good operating environment [26]; second, the use of laparoscopic surgery has smaller wounds than open surgery, so the recovery speed is faster, and the incidence of complications and sequelae is low; third, the use of general anesthesia for laparoscopic technology can further enhance the safety of the operation, and the laparotomy can be replaced according to the progress of the operation [27].At present, the application of laparoscopic technology in the diagnosis and treatment of ovarian cancer is mainly limited to the early clinical stage classification of ovarian cancer and the diagnosis and differential diagnosis of additional stage classification, posttreatment evaluation, and early diagnosis of recurrence [28]. Considering the academic nature, clinical anatomy, and biological diagnosis of ovarian cancer, the clinical application of laparoscopic surgery for advanced ovarian cancer is limited, and there are still many contradictions. Figure 1 is a structural diagram of the basic system of laparoscopy.


## 2.3. Blockchain Technology

Blockchain is a new method of applying decentralized data storage, point-to-point transmission, computer technology [29], consensus mechanism, and encryption algorithm. Blockchain is an important concept of Bitcoin. This is basically a decentralized database. At the same time, like the basic technology of Bitcoin, it is a series of data blocks made using encryption. The data block contains a large amount of Bitcoin transaction information. This is used to verify the validity of the information (to prevent forgery) and create the next information block.Blockchain technology supports the application of laparoscopic technology in the classification of ovarian cancer syndromes. Combining the latest methods of modern medical technology and computer technology, three-dimensional model data about various organs of the human body can be collected through the computer to establish the function of three-dimensional mirroring [30]. This technology can simulate traditional medical endoscopes for endoscopic examination of patients. This is a new way to help diagnose diseases. Because it is a noncontact test tool, it can reduce the patient's pain and reduce the risk of bleeding and infection.Blockchain mainly has the following key characteristics: (1) decentralization: through the use of blockchain technology, there is no need to design a dedicated data center for the hospital [31], and each department only needs to use a consensus algorithm to realize the synchronous update and modification of data; (2) persistence: valid data is added to the blockchain and it is almost impossible to delete or modify; (3) anonymity: each user interacts by hiding his true identity information; (4) auditability: the information in the blockchain is easy to verify or track transaction records.Representative devices of virtual reality technology are removable display screens, data gloves, TELTACT gloves, data suits, etc. The data glove is an input device that converts human hand movements into computer input signals and detects hand movements by connecting position and direction sensors and cables, with optical fibers. It can be applied to ovarian cancer surgery using laparoscopy, and it plays a very important role in minimally invasive surgery.The basic data layer in the blockchain includes hash functions, Merkle trees, encryption algorithms, and time stamps.(1)
Merkle tree: Merkle tree is a kind of data structure. It is very important in the block chain; the main function is to realize the integration of data, so as to obtain the summary information of the transaction data in the block. For the binary tree structure, assuming that the total number of nodes isN, the depth of the tree is depth, and n is the number of leaf nodes; then (1)N≥n+n2+n4+⋯+1=2n−1,(2)log2n+1≤depth≤log2n+2,(3)depth=log2n+1.It can be seen from the above formula that, under the binary tree structure, the total number of nodes and the tree height depth both show linear growth as the number of leaf nodesn increases. Then, for a Merkle tree generated from n data files in blocks, there are the following relations:(4)2m2d−2×m2≤n≤md−1×m.Furthermore, the depth of the multifork Merkle tree is(5)logmn≤depth≤logm/2n2+1.Data integrity verification process:Setup stage: This stage is also called the initialization stage. It mainly constructs the public and private parameters required by the verification process, processes the data file into blocks, and generates the corresponding homomorphic label set and the corresponding multifork Merkle tree structure.(1)
Generate a public-private keypk,sk pair on the client, randomly select the private keyα←Zp, and calculate the corresponding public key v=ga, that is, private key sk=α, public key pk=v.(2)
Perform block processing on the data file to generate a homomorphic label setF=f1,f2,⋯,fn, that isTagBlocksk,F⟶Φ, and use the formula(6)σi=Hfi•ufix|σi∈G,i=1,2,⋯,n.Generate homomorphic labels for each data block, and then form a set of homomorphic labelsΦ=σi1≤i≤n.Challenge stage: At this stage, the client initiates an integrity verification request to the cloud server. (1) Select a random item from the index set [1,n] of the data file management, select the random s1,s2,⋯,slnumber vi of each si, combine the two generation request challenges chal=si,vi1≤i≤l, and send them to the server to start the verification process. (2) The server generates evidence after receiving the verification request, that is, GenProofpk,Φ,chal⟶P, using the data file F, the homomorphic tag set Φ, the client public key pk = (v), and the received challenge chal to construct the integrity of the data file by the following formula:Generate homomorphic labels for each data blockσi, and then form a set of homomorphic labels Φ=σi1≤i≤n.(7)σ=∏i=s1slσivi=∑i=s1slHviviuvisi,μ=∑i=s1slvifi.If the evidence is availableP=σ,μ, the evidence P is sent to the client.(2)
After receiving the evidence, the client executes an algorithmCheckProofpk,chal,P⟶T,F to verify whether the evidence is true; that is, check the equation(8)eσ,g=?e∏i=s1slHvivi⋅uμ,v.


## 3. Using the Electronic Medical Blockchain Technology to Assist the Application Experiment of Laparoscopy in the Comprehensive Staging Operation of Ovarian Cancer

### 3.1. Subjects of Ovarian Cancer Surgery

The research object of this article selected 39 patients who were diagnosed with early-stage ovarian cancer in a hospital from May 2018 to December 2019 and were fully determined by laparoscopic staging. In the control group, 30 patients with early ovarian cancer who chose open surgery during the same period were selected. The selected patients meet the following conditions: (1) No ascites or only a small amount of effusion was found in the examination before the operation; (2) the tumor is obviously located on one or both sides of the ovary; (3) no lesions are found through the equipment inspection metastasis; (4) the diameter of the tumor in the laparoscopic group must be less than 10 cm, and the tumor size in the open group is not limited.All patients are comparable in basic data and pathological data and have statistical significance.Figure 2
Comparison of postoperative pain levels.


### 3.2. Surgical Methods

#### 3.2.1. Laparoscopy Group

(1)
Anesthesia and preoperative preparation: prepare the vagina and intestine for 1 to 3 days, clean the intestine, and fast before the operation. After tracheal intubation and intravenous anesthesia were combined, high bladder stones were removed. Elevate the uterine organs through the vagina. Puncture the upper end of the umbilical cavity and inject carbon dioxide (CO2) through the lung peritoneal needle to form the lung peritoneum. The pulmonary artery pressure was adjusted within the range of 1315 mmHg (1 mHg = 0.1133 kPa), and a 10 mm trocar was inserted into the laparoscope. The second tube and the third tube are placed at 5 mm and 10 mm on the left lower abdomen, respectively, and the fourth tube is placed at 5 mm on the right lower abdomen.(2)
Take peritoneal lavage fluid or ascites for routine cytological examination.(3)
Examine pelvic and abdominal cavity, including suspicious lesions, inner uterus, anus, large intestine on both sides, liver, diaphragm and serous membrane on the surface of the spleen, gastrointestinal tube, and peritoneum on the abdominal wall of the pelvis.(4)
Rapid freezing pathological examination of ovarian tumor: put the side ovarian tumor to be removed into the self-made bag (cut the plastic bag that attracts the trachea neatly along a strip; double the 4th suture at a distance of 11.5°C). Circle with knots at both ends, 1 cm wide, folded in a fan-like fashion, and placed in the pelvic cavity via 10 mm trocar; try to remove the ovarian cysts; or cut off the affected side attachments and put them in the collection bag. Resect from 10 mm trocar in stages and sent for rapid freezing pathological examination; for menopausal patients, ligate bilateral ovarian arteries and veins at a high position, remove the lesion attachments, tie them tightly in the specimen bag, and place them in the right knee fossa.(5)
After the diagnosis of malignancy by cryopreservation, the following operations should be performed for those who do not retain fertility: high treatment of the ovarian blood vessels and removal of the double attachment or the other side attachment; put it into the specimen bag, tie the bag tightly, and leave it in the right iliac fossa. Removal of the uterus: remove the uterus from the vagina and the appendage specimens left in the iliac fossa (sent for quick freezing); the vaginal stump is sutured with two and three stitches, leaving a small opening of about 2 cm in the middle; bilateral pelvic lymph nodes and abdomen para-arterial lymph node were dissected, removed from 1 mm trocar, and marked separately; remove the greater omentum below the transverse colon and place it in the iliac fossa; perform multispot biopsy of the paracolonic groove and pelvic wall peritoneum; intraoperative freezing showed that patients with malignant tumors of epithelial origin received appendectomy. Use toothless oval forceps to take out the excised omentum and appendix from the vaginal stump; as shown in Figure2, suture the vaginal stump to stop bleeding and wash and drain the wound. Only one side of the attachment is removed and the uterus is preserved for those who conform to the preservation of fertility. The rest of the operation steps are the same.


#### 3.2.2. Control Group

After the patient was subjected to general anesthesia, the bladder lithotomy position was taken, and the urinary catheter was inserted after routine disinfection. A longitudinal incision was made on the left side of the center of the lower abdomen, up to 3 cm above the umbilicus, and down to the upper edge of the pubic symphysis. The abdomen was cut into the abdomen, and routine antibiotics were given for 57 days after the operation, the catheter was placed for 2-3 days, the drainage tube was placed, and the abdomen was bandaged with an abdominal band.Young patients with fertility requirements who meet the following conditions will retain their fertility function (reserving the uterus and contralateral appendages): (1) stage IA; (2) well differentiated cells (GI); (3) normal appearance of the contralateral ovary; (4) having follow-up conditions.Figure3 is a comparison chart of surgical methods.Figure 3
Comparison chart of surgical methods.


### 3.3. Observation Indicators

The observation indicators selected in this article are mainly: the operation time of the patient, the amount of bleeding during the operation, postoperative complications, the number of lymph nodes removed, postoperative morbidity, anal exhaust time, and hospital stay. Observation index definitions: (1) operation time refers to the time from the start of operation to the completion of surgical suture; (2) the amount of bleeding during the operation mainly refers to the blood volume actually measured after the operation. The laparoscopic group mainly checks the blood volume in the suction bottle, and the open group is observed by weighing the gauze. In the end, the bleeding during the operation is ≥800 mL, and the blood pressure or pulse is unstable during the operation, and the anesthesia record sheet should be the main one.


### 3.4. Statistical Analysis

The statistical processing of the experimental data in this paper is SPSS17.0, in which the data are represented by standard deviation, and the measurement is witht-test. The experimental standard is set to 0.05. When P<0.05, there are differences between the data items.


## 3.1. Subjects of Ovarian Cancer Surgery

The research object of this article selected 39 patients who were diagnosed with early-stage ovarian cancer in a hospital from May 2018 to December 2019 and were fully determined by laparoscopic staging. In the control group, 30 patients with early ovarian cancer who chose open surgery during the same period were selected. The selected patients meet the following conditions: (1) No ascites or only a small amount of effusion was found in the examination before the operation; (2) the tumor is obviously located on one or both sides of the ovary; (3) no lesions are found through the equipment inspection metastasis; (4) the diameter of the tumor in the laparoscopic group must be less than 10 cm, and the tumor size in the open group is not limited.All patients are comparable in basic data and pathological data and have statistical significance.Figure 2
Comparison of postoperative pain levels.


## 3.2. Surgical Methods

### 3.2.1. Laparoscopy Group

(1)
Anesthesia and preoperative preparation: prepare the vagina and intestine for 1 to 3 days, clean the intestine, and fast before the operation. After tracheal intubation and intravenous anesthesia were combined, high bladder stones were removed. Elevate the uterine organs through the vagina. Puncture the upper end of the umbilical cavity and inject carbon dioxide (CO2) through the lung peritoneal needle to form the lung peritoneum. The pulmonary artery pressure was adjusted within the range of 1315 mmHg (1 mHg = 0.1133 kPa), and a 10 mm trocar was inserted into the laparoscope. The second tube and the third tube are placed at 5 mm and 10 mm on the left lower abdomen, respectively, and the fourth tube is placed at 5 mm on the right lower abdomen.(2)
Take peritoneal lavage fluid or ascites for routine cytological examination.(3)
Examine pelvic and abdominal cavity, including suspicious lesions, inner uterus, anus, large intestine on both sides, liver, diaphragm and serous membrane on the surface of the spleen, gastrointestinal tube, and peritoneum on the abdominal wall of the pelvis.(4)
Rapid freezing pathological examination of ovarian tumor: put the side ovarian tumor to be removed into the self-made bag (cut the plastic bag that attracts the trachea neatly along a strip; double the 4th suture at a distance of 11.5°C). Circle with knots at both ends, 1 cm wide, folded in a fan-like fashion, and placed in the pelvic cavity via 10 mm trocar; try to remove the ovarian cysts; or cut off the affected side attachments and put them in the collection bag. Resect from 10 mm trocar in stages and sent for rapid freezing pathological examination; for menopausal patients, ligate bilateral ovarian arteries and veins at a high position, remove the lesion attachments, tie them tightly in the specimen bag, and place them in the right knee fossa.(5)
After the diagnosis of malignancy by cryopreservation, the following operations should be performed for those who do not retain fertility: high treatment of the ovarian blood vessels and removal of the double attachment or the other side attachment; put it into the specimen bag, tie the bag tightly, and leave it in the right iliac fossa. Removal of the uterus: remove the uterus from the vagina and the appendage specimens left in the iliac fossa (sent for quick freezing); the vaginal stump is sutured with two and three stitches, leaving a small opening of about 2 cm in the middle; bilateral pelvic lymph nodes and abdomen para-arterial lymph node were dissected, removed from 1 mm trocar, and marked separately; remove the greater omentum below the transverse colon and place it in the iliac fossa; perform multispot biopsy of the paracolonic groove and pelvic wall peritoneum; intraoperative freezing showed that patients with malignant tumors of epithelial origin received appendectomy. Use toothless oval forceps to take out the excised omentum and appendix from the vaginal stump; as shown in Figure2, suture the vaginal stump to stop bleeding and wash and drain the wound. Only one side of the attachment is removed and the uterus is preserved for those who conform to the preservation of fertility. The rest of the operation steps are the same.


### 3.2.2. Control Group

After the patient was subjected to general anesthesia, the bladder lithotomy position was taken, and the urinary catheter was inserted after routine disinfection. A longitudinal incision was made on the left side of the center of the lower abdomen, up to 3 cm above the umbilicus, and down to the upper edge of the pubic symphysis. The abdomen was cut into the abdomen, and routine antibiotics were given for 57 days after the operation, the catheter was placed for 2-3 days, the drainage tube was placed, and the abdomen was bandaged with an abdominal band.Young patients with fertility requirements who meet the following conditions will retain their fertility function (reserving the uterus and contralateral appendages): (1) stage IA; (2) well differentiated cells (GI); (3) normal appearance of the contralateral ovary; (4) having follow-up conditions.Figure3 is a comparison chart of surgical methods.Figure 3
Comparison chart of surgical methods.


## 3.2.1. Laparoscopy Group

(1)
Anesthesia and preoperative preparation: prepare the vagina and intestine for 1 to 3 days, clean the intestine, and fast before the operation. After tracheal intubation and intravenous anesthesia were combined, high bladder stones were removed. Elevate the uterine organs through the vagina. Puncture the upper end of the umbilical cavity and inject carbon dioxide (CO2) through the lung peritoneal needle to form the lung peritoneum. The pulmonary artery pressure was adjusted within the range of 1315 mmHg (1 mHg = 0.1133 kPa), and a 10 mm trocar was inserted into the laparoscope. The second tube and the third tube are placed at 5 mm and 10 mm on the left lower abdomen, respectively, and the fourth tube is placed at 5 mm on the right lower abdomen.(2)
Take peritoneal lavage fluid or ascites for routine cytological examination.(3)
Examine pelvic and abdominal cavity, including suspicious lesions, inner uterus, anus, large intestine on both sides, liver, diaphragm and serous membrane on the surface of the spleen, gastrointestinal tube, and peritoneum on the abdominal wall of the pelvis.(4)
Rapid freezing pathological examination of ovarian tumor: put the side ovarian tumor to be removed into the self-made bag (cut the plastic bag that attracts the trachea neatly along a strip; double the 4th suture at a distance of 11.5°C). Circle with knots at both ends, 1 cm wide, folded in a fan-like fashion, and placed in the pelvic cavity via 10 mm trocar; try to remove the ovarian cysts; or cut off the affected side attachments and put them in the collection bag. Resect from 10 mm trocar in stages and sent for rapid freezing pathological examination; for menopausal patients, ligate bilateral ovarian arteries and veins at a high position, remove the lesion attachments, tie them tightly in the specimen bag, and place them in the right knee fossa.(5)
After the diagnosis of malignancy by cryopreservation, the following operations should be performed for those who do not retain fertility: high treatment of the ovarian blood vessels and removal of the double attachment or the other side attachment; put it into the specimen bag, tie the bag tightly, and leave it in the right iliac fossa. Removal of the uterus: remove the uterus from the vagina and the appendage specimens left in the iliac fossa (sent for quick freezing); the vaginal stump is sutured with two and three stitches, leaving a small opening of about 2 cm in the middle; bilateral pelvic lymph nodes and abdomen para-arterial lymph node were dissected, removed from 1 mm trocar, and marked separately; remove the greater omentum below the transverse colon and place it in the iliac fossa; perform multispot biopsy of the paracolonic groove and pelvic wall peritoneum; intraoperative freezing showed that patients with malignant tumors of epithelial origin received appendectomy. Use toothless oval forceps to take out the excised omentum and appendix from the vaginal stump; as shown in Figure2, suture the vaginal stump to stop bleeding and wash and drain the wound. Only one side of the attachment is removed and the uterus is preserved for those who conform to the preservation of fertility. The rest of the operation steps are the same.


## 3.2.2. Control Group

After the patient was subjected to general anesthesia, the bladder lithotomy position was taken, and the urinary catheter was inserted after routine disinfection. A longitudinal incision was made on the left side of the center of the lower abdomen, up to 3 cm above the umbilicus, and down to the upper edge of the pubic symphysis. The abdomen was cut into the abdomen, and routine antibiotics were given for 57 days after the operation, the catheter was placed for 2-3 days, the drainage tube was placed, and the abdomen was bandaged with an abdominal band.Young patients with fertility requirements who meet the following conditions will retain their fertility function (reserving the uterus and contralateral appendages): (1) stage IA; (2) well differentiated cells (GI); (3) normal appearance of the contralateral ovary; (4) having follow-up conditions.Figure3 is a comparison chart of surgical methods.Figure 3
Comparison chart of surgical methods.


## 3.3. Observation Indicators

The observation indicators selected in this article are mainly: the operation time of the patient, the amount of bleeding during the operation, postoperative complications, the number of lymph nodes removed, postoperative morbidity, anal exhaust time, and hospital stay. Observation index definitions: (1) operation time refers to the time from the start of operation to the completion of surgical suture; (2) the amount of bleeding during the operation mainly refers to the blood volume actually measured after the operation. The laparoscopic group mainly checks the blood volume in the suction bottle, and the open group is observed by weighing the gauze. In the end, the bleeding during the operation is ≥800 mL, and the blood pressure or pulse is unstable during the operation, and the anesthesia record sheet should be the main one.


## 3.4. Statistical Analysis

The statistical processing of the experimental data in this paper is SPSS17.0, in which the data are represented by standard deviation, and the measurement is witht-test. The experimental standard is set to 0.05. When P<0.05, there are differences between the data items.


## 4. Application Analysis of Laparoscopy in Comprehensive Staging of Ovarian Cancer Based on Electronic Medical Blockchain Technology

### 4.1. Application Analysis of Blockchain Technology-Assisted Laparoscopy in Ovarian Cancer Surgery

It can be seen from Table1 that the initial stage of ovarian cancer includes stage I and stage II of FIGO. Now, according to the surgical stage and histological grade (G), it is classified into low-risk type and high-risk type. The first stage includes stage I or stage II and G1 stage or G2 stage, and the reversal rate is 5% to 10%. The second stage includes all patients of stage II and stage I, and the recurrence rate of G and tissue cell carcinoma is 30%–40%. According to the adoption of NCCN2011 ovarian cancer treatment guidelines in the United States, the treatment principles after “high-risk stage I” and “stage I risk” (“heterogeneous components,” etc.)) have been added, as well as the same treatment principles as stage I high-risk. Now it is mainly considered that low patients at risk do not need immunity. In inhibitor therapy, patients at high risk can choose simple treatments and a limited series of chemotherapy, that is, 3 to 6 cycles of combined chemotherapy with 1 or 2 drugs, usually less than 6 cycles. However, patients with simple malignant cell carcinoma must be treated in accordance with the principles.Table 1
Early ovarian cancer classification.
Early ovarian cancer classificationTypesDetailsRecurrence rateFIGO phase ILow riskStage IA or IB, G1 or G25%–10%PeriodΠHigh riskPeriodΠ, IC period, G330%–40%According to the survey opinions, there are three patients in the laparoscopic group who want to undergo minimally invasive surgery and preserve fertility, and the open group has 4 cases of the same. The clinical data in Table2 and Figure 4 show that, except for the tumor diameter P<0.05, which is not comparable, other comparison items are comparable and different.Table 2
Comparison of the basic data of the two groups of patients.
GroupNumber of casesAgeBody weight (kg)Tumor diameter (cm)CA125 (mL)Abdominal surgery history/caseLaparoscopy group3942.32±13.7256.11±10.486.76±3.85109.67±176.426Open abdominal group3041.54±11.2459.25±12.1813.45±7.53132.45±141.728P—>0.05>0.05<0.05>0.05>0.05Figure 4
Comparison of the basic data of the two groups of patients.According to the pathological data in Table3 and Figure 5, the surgical pathological staging is 6 stages, namely, IA, IB, IC, ∏A, ∏B, and ∏C. The histological type of tumor is divided into epithelial origin and sexual interstitium, and the degree of tumor differentiation is divided into high school and low third. There are no significant differences between the laparoscopic group and the laparotomy group for the three pathological conditions in the table, P>0.05.Table 3
Comparison of pathological data between the two groups.
GroupLaparoscopic groupControl groupP valueNumber of cases3930Surgical pathological stagingIA1917>0.05IB611IC23∏A11>0.05∏B12∏C01Histological type of tumorEpithelial origin2631>0.05Sex cord stroma12Tumor differentiationHigh1110>0.05Middle1713Low12Figure 5
Comparison of pathological data between the two groups.


### 4.2. Comparative Analysis of the Two Groups of Patients before and after Surgery

It can be seen from Table4 and Figure 6 that the number of pelvic lymphadenectomies, the number of abdominal lymphadenectomies, and the operation times of the laparoscopic group and the laparotomy group are not much different, and P>0.05, so the comparison has no statistically significant characteristics. However, from the perspective of intraoperative blood loss and intraoperative blood transfusion, the intraoperative blood loss of the control group was 141.1 ml, and the intraoperative blood loss of the laparoscopic group was 103.5 ml. It can be seen that the laparoscopic group had less blood loss. In addition, there was no case in the laparoscopic group that required intraoperative blood transfusion, and 6 cases in the laparotomy group required intraoperative blood transfusion, accounting for 28.57%. In summary, the laparoscopic group has less bleeding than the open group, and the operation is safer.Table 4
Comparison of intraoperative conditions between the two groups.
GroupNumber of casesNumber of pelvic lymphadenectomiesNumber of abdominal lymphadenectomiesOperation timeIntraoperative blood loss (ml)Proportion of people in need of blood transfusion (n (%))New technology laparoscopic group3926.56.4261.3103.50(0)Control group3024.25.5258.6141.16(28.57)T value0.96730.82500.42322.6889—X2 value————4.8611P value>0.05>0.05>0.05<0.05<0.05Figure 6
Comparison of intraoperative conditions between the two groups.As shown in Table5 and Figure 7, the postoperative state of the two groups was compared. Patients in both groups received VAS pain scores after surgery. The average score of the test group was lower than the average score of the control group (P<0.05). The incidence of complications during and after the use of antibiotics was significantly lower than that of the control group (P<0.05). After a year of follow-up investigation, the recurrence rate of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05).Table 5
Comparison of postoperative conditions between the two groups.
GroupNumber of casesPostoperative pain score (VAS)Postoperative exhaust time (d)Antibiotic use time (d)Incidence of postoperative complications (n (%))The recurrence rate was followed up for 1 year (n (%))New technology laparoscopic group392.81.72.11(4.76)2(9.52)Control group303.72.13.27(33.33)9(42.86)T value2.23672.13092.6830——X2 value———3.86036.0353P value<0.05<0.05<0.05<0.05<0.05Figure 7
Comparison of postoperative conditions between the two groups.The intraoperative blood loss of the abdominal surgery group was significantly less than that of the previous laparotomy group (P<0.05), which reduced the number of patients requiring blood transfusion during the operation and at the same time reduced the possibility of infection due to side effects and blood transfusion due to medical accidents. Compared to open surgery, it is not important for laparoscopic surgery itself. Second, laparoscopic surgery, using energy devices such as single and bipolar ultrasonic knives, confirms the close relationship between opening and hemostasis. Therefore, hemostasis is rapid and wide, and in terms of VAS pain score, the experimental group is significantly better than the control group in terms of postoperative exhaust time, antibiotic use time, postoperative complication rate (P<0.05), and 1-year postoperative monitoring. The recurrence rate of patients in the treatment group was lower than that in the control group (P<0.05).It can be seen from Table6 and Figure 8 that the tumor rupture rate of laparoscopic surgery is 12–20%, while that of open surgery is only 10%, indicating that the tumor rupture rate of laparoscopic ovarian cancer is higher than that of open surgery. In addition, when the tumor volume is large, it can significantly increase the intraoperative tumor rupture rate. Therefore, when the ovarian cancer tumor is large, laparoscopic surgery is not suitable. In addition, the incision metastasis rate after ovarian cancer reaches 0–20%, the incision metastasis rate after laparoscopic surgery is 1.18%, and the incision metastasis rate after open surgery is 5.2%, so laparoscopic surgery is better than open surgery in this respect better. Since laparoscopic surgery is a minimally invasive operation, CO2 pneumoperitoneum has little effect on the growth of the body and tumor cells during the operation, but it needs to be carefully selected for abnormal cardiopulmonary function and elderly patients.Table 6
Challenges faced by laparoscopic surgery in the treatment of ovarian cancer.
ChallengeProbability of laparoscopic surgery (%)Probability of open surgery (%)Tumor capsule ruptured12–2010Postoperative incision transfer1.185.2How the pneumoperitoneum affects the body510.2Figure 8
Challenges faced by laparoscopic surgery in the treatment of ovarian cancer.It can be seen from Table7 and Figure 2 that the comparison of pain levels after surgery is relatively obvious. Among the three grades of pain, the proportion of the laparotomy group is 31.82%, and the proportion of the laparoscopy group is 11.37%. The abdominal group has more pain than the laparoscopic group, and the reason is that the laparoscopic group performs minimally invasive surgery, with smaller wounds and better results. Moreover, the proportion of painless operations in the laparoscopic group reached 50%, indicating that people would prefer painless operations.Table 7
Comparison of postoperative pain levels.
GroupNumber of casesGrade 0 painGrade I painGrade II painGrade III painNew technology laparoscopic group3922(50.00)12(27.28)5(11.37)5(11.37)Control group308(18.18)10(22.74)12(27.27)14(31.82)From the survey results in Table8 and Figure 9, it can be seen that the overall satisfaction of the observation group (97.73%) is significantly higher than that of the control group (65.91%). The observation group has a pain probability of grade III (11.36%) and a pain of grade III. The probability was significantly lower than that of the control group (31.82%), and the difference was statistically significant (P<0.05). The application of comprehensive care for ovarian tumor surgery can improve the treatment effect. This study shows that traditional treatment alone can no longer meet the needs of patients, and the treatment effect is very low. Comprehensive care is carried out in preoperative psychology, postoperative pain transmission, postoperative health education, and pain. It has a good treatment effect and can improve patient satisfaction.Table 8
Comparison of postoperative satisfaction (n (%)).
GroupNumber of casesVery satisfiedQuite satisfiedNot satisfiedOverall satisfactionNew technology laparoscopic group3935(79.55)8(18.18)1(2.27)97.73Control group3010(22.73)19(43.18)15(34.09)65.91Figure 9
Comparison of postoperative satisfaction (n (%).


## 4.1. Application Analysis of Blockchain Technology-Assisted Laparoscopy in Ovarian Cancer Surgery

It can be seen from Table1 that the initial stage of ovarian cancer includes stage I and stage II of FIGO. Now, according to the surgical stage and histological grade (G), it is classified into low-risk type and high-risk type. The first stage includes stage I or stage II and G1 stage or G2 stage, and the reversal rate is 5% to 10%. The second stage includes all patients of stage II and stage I, and the recurrence rate of G and tissue cell carcinoma is 30%–40%. According to the adoption of NCCN2011 ovarian cancer treatment guidelines in the United States, the treatment principles after “high-risk stage I” and “stage I risk” (“heterogeneous components,” etc.)) have been added, as well as the same treatment principles as stage I high-risk. Now it is mainly considered that low patients at risk do not need immunity. In inhibitor therapy, patients at high risk can choose simple treatments and a limited series of chemotherapy, that is, 3 to 6 cycles of combined chemotherapy with 1 or 2 drugs, usually less than 6 cycles. However, patients with simple malignant cell carcinoma must be treated in accordance with the principles.Table 1
Early ovarian cancer classification.
Early ovarian cancer classificationTypesDetailsRecurrence rateFIGO phase ILow riskStage IA or IB, G1 or G25%–10%PeriodΠHigh riskPeriodΠ, IC period, G330%–40%According to the survey opinions, there are three patients in the laparoscopic group who want to undergo minimally invasive surgery and preserve fertility, and the open group has 4 cases of the same. The clinical data in Table2 and Figure 4 show that, except for the tumor diameter P<0.05, which is not comparable, other comparison items are comparable and different.Table 2
Comparison of the basic data of the two groups of patients.
GroupNumber of casesAgeBody weight (kg)Tumor diameter (cm)CA125 (mL)Abdominal surgery history/caseLaparoscopy group3942.32±13.7256.11±10.486.76±3.85109.67±176.426Open abdominal group3041.54±11.2459.25±12.1813.45±7.53132.45±141.728P—>0.05>0.05<0.05>0.05>0.05Figure 4
Comparison of the basic data of the two groups of patients.According to the pathological data in Table3 and Figure 5, the surgical pathological staging is 6 stages, namely, IA, IB, IC, ∏A, ∏B, and ∏C. The histological type of tumor is divided into epithelial origin and sexual interstitium, and the degree of tumor differentiation is divided into high school and low third. There are no significant differences between the laparoscopic group and the laparotomy group for the three pathological conditions in the table, P>0.05.Table 3
Comparison of pathological data between the two groups.
GroupLaparoscopic groupControl groupP valueNumber of cases3930Surgical pathological stagingIA1917>0.05IB611IC23∏A11>0.05∏B12∏C01Histological type of tumorEpithelial origin2631>0.05Sex cord stroma12Tumor differentiationHigh1110>0.05Middle1713Low12Figure 5
Comparison of pathological data between the two groups.


## 4.2. Comparative Analysis of the Two Groups of Patients before and after Surgery

It can be seen from Table4 and Figure 6 that the number of pelvic lymphadenectomies, the number of abdominal lymphadenectomies, and the operation times of the laparoscopic group and the laparotomy group are not much different, and P>0.05, so the comparison has no statistically significant characteristics. However, from the perspective of intraoperative blood loss and intraoperative blood transfusion, the intraoperative blood loss of the control group was 141.1 ml, and the intraoperative blood loss of the laparoscopic group was 103.5 ml. It can be seen that the laparoscopic group had less blood loss. In addition, there was no case in the laparoscopic group that required intraoperative blood transfusion, and 6 cases in the laparotomy group required intraoperative blood transfusion, accounting for 28.57%. In summary, the laparoscopic group has less bleeding than the open group, and the operation is safer.Table 4
Comparison of intraoperative conditions between the two groups.
GroupNumber of casesNumber of pelvic lymphadenectomiesNumber of abdominal lymphadenectomiesOperation timeIntraoperative blood loss (ml)Proportion of people in need of blood transfusion (n (%))New technology laparoscopic group3926.56.4261.3103.50(0)Control group3024.25.5258.6141.16(28.57)T value0.96730.82500.42322.6889—X2 value————4.8611P value>0.05>0.05>0.05<0.05<0.05Figure 6
Comparison of intraoperative conditions between the two groups.As shown in Table5 and Figure 7, the postoperative state of the two groups was compared. Patients in both groups received VAS pain scores after surgery. The average score of the test group was lower than the average score of the control group (P<0.05). The incidence of complications during and after the use of antibiotics was significantly lower than that of the control group (P<0.05). After a year of follow-up investigation, the recurrence rate of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05).Table 5
Comparison of postoperative conditions between the two groups.
GroupNumber of casesPostoperative pain score (VAS)Postoperative exhaust time (d)Antibiotic use time (d)Incidence of postoperative complications (n (%))The recurrence rate was followed up for 1 year (n (%))New technology laparoscopic group392.81.72.11(4.76)2(9.52)Control group303.72.13.27(33.33)9(42.86)T value2.23672.13092.6830——X2 value———3.86036.0353P value<0.05<0.05<0.05<0.05<0.05Figure 7
Comparison of postoperative conditions between the two groups.The intraoperative blood loss of the abdominal surgery group was significantly less than that of the previous laparotomy group (P<0.05), which reduced the number of patients requiring blood transfusion during the operation and at the same time reduced the possibility of infection due to side effects and blood transfusion due to medical accidents. Compared to open surgery, it is not important for laparoscopic surgery itself. Second, laparoscopic surgery, using energy devices such as single and bipolar ultrasonic knives, confirms the close relationship between opening and hemostasis. Therefore, hemostasis is rapid and wide, and in terms of VAS pain score, the experimental group is significantly better than the control group in terms of postoperative exhaust time, antibiotic use time, postoperative complication rate (P<0.05), and 1-year postoperative monitoring. The recurrence rate of patients in the treatment group was lower than that in the control group (P<0.05).It can be seen from Table6 and Figure 8 that the tumor rupture rate of laparoscopic surgery is 12–20%, while that of open surgery is only 10%, indicating that the tumor rupture rate of laparoscopic ovarian cancer is higher than that of open surgery. In addition, when the tumor volume is large, it can significantly increase the intraoperative tumor rupture rate. Therefore, when the ovarian cancer tumor is large, laparoscopic surgery is not suitable. In addition, the incision metastasis rate after ovarian cancer reaches 0–20%, the incision metastasis rate after laparoscopic surgery is 1.18%, and the incision metastasis rate after open surgery is 5.2%, so laparoscopic surgery is better than open surgery in this respect better. Since laparoscopic surgery is a minimally invasive operation, CO2 pneumoperitoneum has little effect on the growth of the body and tumor cells during the operation, but it needs to be carefully selected for abnormal cardiopulmonary function and elderly patients.Table 6
Challenges faced by laparoscopic surgery in the treatment of ovarian cancer.
ChallengeProbability of laparoscopic surgery (%)Probability of open surgery (%)Tumor capsule ruptured12–2010Postoperative incision transfer1.185.2How the pneumoperitoneum affects the body510.2Figure 8
Challenges faced by laparoscopic surgery in the treatment of ovarian cancer.It can be seen from Table7 and Figure 2 that the comparison of pain levels after surgery is relatively obvious. Among the three grades of pain, the proportion of the laparotomy group is 31.82%, and the proportion of the laparoscopy group is 11.37%. The abdominal group has more pain than the laparoscopic group, and the reason is that the laparoscopic group performs minimally invasive surgery, with smaller wounds and better results. Moreover, the proportion of painless operations in the laparoscopic group reached 50%, indicating that people would prefer painless operations.Table 7
Comparison of postoperative pain levels.
GroupNumber of casesGrade 0 painGrade I painGrade II painGrade III painNew technology laparoscopic group3922(50.00)12(27.28)5(11.37)5(11.37)Control group308(18.18)10(22.74)12(27.27)14(31.82)From the survey results in Table8 and Figure 9, it can be seen that the overall satisfaction of the observation group (97.73%) is significantly higher than that of the control group (65.91%). The observation group has a pain probability of grade III (11.36%) and a pain of grade III. The probability was significantly lower than that of the control group (31.82%), and the difference was statistically significant (P<0.05). The application of comprehensive care for ovarian tumor surgery can improve the treatment effect. This study shows that traditional treatment alone can no longer meet the needs of patients, and the treatment effect is very low. Comprehensive care is carried out in preoperative psychology, postoperative pain transmission, postoperative health education, and pain. It has a good treatment effect and can improve patient satisfaction.Table 8
Comparison of postoperative satisfaction (n (%)).
GroupNumber of casesVery satisfiedQuite satisfiedNot satisfiedOverall satisfactionNew technology laparoscopic group3935(79.55)8(18.18)1(2.27)97.73Control group3010(22.73)19(43.18)15(34.09)65.91Figure 9
Comparison of postoperative satisfaction (n (%).


## 5. Conclusion

This article mainly studies the application of laparoscopy in the comprehensive staging operation of ovarian cancer based on electronic medical blockchain technology. This article adopts the method of literature data, absorbing previous experimental research results and carrying out innovative applications. Through in-depth study of blockchain technology, laparoscopy, and ovarian cancer, it briefly explained the clinical symptoms and surgical classification of ovarian cancer, the specific application of laparoscopy, and the application of blockchain technology and designed an electronic medical blockchain technology support. The application experiment of laparoscopy in the comprehensive staging operation of ovarian cancer analyzes the advantages of laparoscopy assisted by blockchain technology in ovarian cancer surgery compared with the traditional laparotomy, which shows the advantages of blockchain technology. Laparoscopic surgery can be better used in the treatment of ovarian cancer.The innovation of this article lies in, first, the combination of qualitative research and quantitative research, as can be seen from the fourth part of this article; second, the combination of theoretical research and empirical research; this innovation runs through the whole text in the abdominal cavity. In terms of the technology of the mirror itself, it is analyzed in combination with the clinical application of ovarian cancer surgery, so as to fully explain the advantages of laparoscopy. Third, it makes full use of high-tech computer technology—the combination of blockchain technology and medical technical research—to promote the development and innovation of the medical field.This article still has some shortcomings. Firstly, the laparoscopic equipment is expensive and the operation is more complicated. It is best to operate under the guidance of professionals; secondly, laparoscopic surgery cannot be used when the tumor diameter is too large, and it may be necessary to temporarily switch to open surgery according to the patient's condition, which also increases the risk of surgery to a certain extent. However, the application of blockchain technology-assisted laparoscopy in the comprehensive staging of ovarian cancer will definitely become more and more extensive. At the same time, I hope that the research in this article can make a little contribution to the medical career.



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*Source: 6649640-2021-04-08.xml*