Ms. Zhang is 45 years old and works as a finance worker in a trading company. She is usually busy and stressed, and has been showing signs of depression for some time. Six months ago she often felt heartburn and regurgitation, sometimes accompanied by persistent retrosternal pain and difficulty in swallowing. This condition was also associated with a change in position, and the heartburn was more pronounced when she was in a recumbent position or bent over, and gradually relieved after sitting up or swallowing liquids. After the initial diagnosis, she was suspected of having GERD, which was confirmed by further gastroscopy and esophageal pH monitoring. Gastroesophageal Reflux Disease (GERD) refers to the reflux of gastroduodenal contents into the esophagus causing acid reflux, heartburn, chest pain and other symptoms, and can lead to reflux esophagitis and extraesophageal (oropharynx, larynx, airway, etc.) tissue damage, mainly including reflux esophagitis and esophageal hiatus hernia. GERD has gradually become a common disease that seriously threatens people’s health and affects their quality of life, with a prevalence rate of 9% in the population. The main pathogenesis of GERD is the weakening of the anti-reflux barrier at the gastroesophageal junction, the loss of the high-pressure zone that prevents reflux of gastric contents, and the insufficient gastroesophageal motility to effectively remove reflux and gastric contents from the esophagus. Those with a combined esophageal hiatal hernia are associated with a weak or defective septal muscle that allows some gastric tissue to burrow from the abdominal cavity into the thoracic cavity. The diagnosis of GERD can be made by endoscopy and gastrointestinal imaging in patients with typical symptoms, but in patients with atypical reflux symptoms, a combination of endoscopy, esophageal kinetics and experimental treatment is required. 24 h esophageal pH monitoring is a valuable method to determine GERD, with a normal pH of 6 and a drop below 4 indicating the presence of reflux. On examination, Ms. Zhang had moderate reflux esophagitis and a mild esophageal hiatal hernia, so the gastroenterologist gave her a combination of medications, including gastroprokinetic drugs, proton pump inhibitors, mucosal protectors, and additional antidepressants. At first, Ms. Zhang’s symptoms were significantly relieved, but when the medication was reduced, the symptoms worsened again, and after 3 months of maintenance medication, severe iron deficiency anemia developed due to the long-term use of acid-producing drugs. It turned out that GERD is a chronic disease with recurrent attacks, and some patients need long-term treatment to prevent the emergence of complications and recurrence, but the most commonly used proton pump inhibitors in clinical treatment can produce many adverse effects after long-term use. Ms. Zhang was then transferred from the Department of Gastroenterology to the Department of General Surgery, where she underwent laparoscopic anti-reflux surgery, including fundoplication combined with esophageal hiatal hernia repair. She was discharged from the hospital 5 days after the operation, and 2 months after the operation, her symptoms basically disappeared and she stopped taking oral medication completely, and her anemia was gradually corrected. Anti-reflux surgery, mainly fundoplication and, if necessary, combined with esophageal hiatal hernia repair, is performed to treat GERD by reconstructing the anti-reflux barrier at the gastroesophageal junction and restoring its high-pressure zone. In severe reflux with esophageal hiatal hernia, surgery is suitable for those whose symptoms are not relieved by conventional medical treatment, those who relapse after regular treatment with proton pump inhibitors, and those with high reflux and swallowing difficulties. Laparoscopic anti-reflux surgery is less traumatic, faster recovery, less complications than traditional open surgery, and the effect is no different from that of open surgery, which is a safe and economical treatment means, and has shown its obvious advantages compared with traditional surgery or long-term drug treatment, and is gradually accepted by the majority of physicians and patients. Many patients with GERD, like Ms. Zhang, have been significantly relieved or even cured by laparoscopic anti-reflux surgery.