Layer by layer, a thread of separation, cut off, the presence of visiting experts as if in a science fiction novel, “enjoying” the operation …… Beijing Tongren Hospital Professor Wu Jixiang is using 3D laparoscopy for a cardia laxity patients with modified Heller plus gastric folding surgery. The bottom-folding surgery. Xiao Hong (a pseudonym), 44 years old, is an ordinary worker with a cheerful personality, loves to sing and dance, and is loved by his colleagues. Just whenever the colleagues are happy, mutual appointment to eat together, she has avoided. It’s not that Xiaohong does not like to be happy with the guys, but she has a troubled 15 years of their own suffering. At the age of 30, Xiao Hong, she found that when eating laborious, sometimes light and sometimes heavy. The local hospital, the examination did not find obvious abnormalities. 10 years ago, the eating effort is more serious, work, study the more nervous the more obvious. After hearing doctors say that Peking Tongren Hospital is good at diagnosing and treating esophageal diseases, she found Peking Tongren Hospital to find the root cause of the disease. Associate Professor Yu Lei of the Department of Thoracic Surgery conducted gastroscopy and upper gastrointestinal imaging, and found that the position of the cardia was narrowed, and esophageal manometry showed that the resting pressure of the lower part of the esophagus was increased, with abnormal peristalsis of the esophageal body, and the diagnosis was: pancreatic achalasia. Xiao Hong disagreed with the surgical treatment plan of small abdominal incision, and after 15 days of stent dilatation treatment, the patient’s feeding effort improved significantly. However, the symptom reappeared 6-7 years ago, and with the prolongation of time, now even if he eats liquid food, he has to drink a lot of water to help swallow, and sometimes the water he drinks is vomited out 30 minutes-1 hour after eating. He found Associate Professor Yu Lei again to seek a solution. Associate Professor Yu Lei told Xiao Hong: Peking Tongren Hospital has been engaged in the diagnosis and treatment of esophageal diseases through multidisciplinary collaboration. In recent years, the use of laparoscopy to treat functional esophageal diseases such as pancreatic achalasia, reflux esophagitis, hiatal hernia, etc. has achieved very good results. on July 21, 2013, Xiaohong finally agreed to laparoscopic surgery. On July 24, 2013, at 7:00 p.m., a multidisciplinary symposium chaired by Prof. Jixiang Wu, President of Peking Tongren Hospital and a doctoral supervisor, was in progress. Participants included Professor Li Jianye and Associate Professor Yu Lei from the Department of Thoracic Surgery, Professor Qian Dongmei from the Department of Gastroenterology, and Professor Tian Qichang from the Department of Radiology. The discussion is about how to treat Xiao Hong’s pancreatic achalasia using 3D laparoscopic surgery, which not only has the advantages of normal laparoscopy (less trauma, quicker recovery, fewer complications, and easier acceptance by the patient, etc.), but also provides more comprehensive and detailed anatomical details, which improves surgical results and saves surgical time to a certain extent. Especially in separating blood vessels, displaying fine structures and restoring the sense of surgical hierarchy, it has the advantages that ordinary laparoscopy can not be compared. These features determine that 3D laparoscopy will play a more valuable role in modified Heller surgery (lower esophageal myotomy). Dysphagia, the most common complication after Heller surgery, is mainly caused by incomplete lower esophageal sphincterotomy. In particular, the cricoid muscle, which is close to the esophageal mucosa, is not easy to be detected and judged under open and normal laparoscopy because of the slenderness of the cricoid muscle bundles (usually thinner than a hairline), which are in close proximity to the mucosa. Misjudgment by some surgeons leads to intraoperative esophageal mucosal rupture. Most surgeons use gauze to rub repeatedly on the surface of the esophageal mucosa. On July 26, 2013 at 9:00 am in the operating room of Peking Tongren Hospital, Prof. Jixiang Wu successfully performed a modified Heller plus gastric fundoplication surgery for Xiao Hong. Prof. Jixiang Wu made full use of the 3D laparoscopic surgery to simulate the characteristics of binocular three-dimensional stereoscopic imaging and high-definition magnification of the field of view, and not only operated in a delicate way, but also detached the circular muscle bundles one by one from the surface of esophageal mucosa and cut them off ultrasonically, and also sensed the length of cutting the esophageal muscularis layer and the gastric muscularis layer in the longitudinal and deep direction, which avoided the excessive damage to gastric lasso fibers, and reduced the possibility of postoperative complications of reflux esophagitis. Intraoperative gastroscope cooperation, lower esophageal sphincter incision site pumping shows that the esophageal mucosa expansion is complete, and the lower esophageal incision is adequate. On the second postoperative day, Xiaohong asked the doctor happily when he got out of bed, “Did I really have the surgery? On the third postoperative day, Xiao Hong asked the doctor with a glass of milk in the morning, “Have I really suffered from pancreatic achalasia? 。。。。。。 It is reported that, as one of the early pioneers of laparoscopic surgery in China, Prof. Jixiang Wu has led the Surgery Center of Peking Tongren Hospital to actively promote 3D laparoscopic surgery, and has successively applied this technology in gastrointestinal, liver, urological tumors, and gynecological surgeries. He also plans to establish a minimally invasive surgery training and exchange center to popularize and promote minimally invasive surgery techniques for the benefit of patients. The multidisciplinary discussion hosted by Prof. Jixiang Wu was attended by many experts, including Prof. Jianye Li and Associate Prof. Lei Yu from Department of Thoracic Surgery, Prof. Dongmei Qian from Department of Gastroenterology and Prof. Qichang Tian from Department of Radiology. Prof. Jixiang Wu and Associate Prof. Lei Yu performing modified Heller plus fundoplication using 3D laparoscopy.