What are the risks and complications of this surgery? Laparoscopic surgery, some people call it eye-punching surgery, or keyhole surgery abroad, representing that it is minimally invasive and relatively low-risk. Many people have heard of laparoscopic gallbladder surgery and laparoscopic appendectomy, but in fact laparoscopic fundoplication is similar to these surgeries in terms of risk, only slightly more difficult. In order to get the patient through the perioperative period safely, we need to assess whether the patient’s cardiopulmonary function can tolerate the surgery and anesthesia before surgery. In addition, it is important to determine whether the patient has a combined giant esophageal hiatal hernia and a history of previous abdominal surgery to determine the difficulty and timing of the procedure, and if necessary, to have two experienced laparoscopic surgeons work together to reduce the risk. Are there any special preoperative and postoperative considerations for patients? The preoperative preparation for fundoplication is not very different from other surgeries: fasting and abstaining from water before the surgery and resting well in anticipation of the surgery. Usually you need to stay in the hospital for one or two days after the operation. On the first day after the operation, you should start to let the patient drink a small amount of water and encourage him/her to get out of bed. Before discharge, an upper gastrointestinal tract imaging, or barium meal, is required to confirm that the patient has no more reflux. The majority of patients will experience a little abdominal distention within a week after surgery, which is a normal reaction in the early postoperative period after fundoplication. Because the lower esophageal sphincter was in a loose state for a long time, it will take a little time to adjust to the normal state now that it has been tightened. I usually ask the patient if he feels a little bloated after drinking water during the postoperative checkup. Ideally, the patient would tell me that he feels a little bloated and a little nauseous. This means that the anti-reflux valve is very effective, and the postoperative bloating will quickly improve and disappear through dietary guidance, and if necessary, a small amount of gastric power medication can be taken. There will be a little incisional pain in the early postoperative period, which usually disappears completely in three to five days. In addition, the majority of patients will have shoulder pain after laparoscopic surgery because laparoscopic surgery requires the creation of an artificial pneumoperitoneum, and the carbon dioxide gas that fills the abdominal cavity can irritate the subdiaphragm and cause radiating pain. It usually disappears in three to five days. There is no other significant discomfort. How long does the surgery usually take and how long is the hospital stay? What is the cost required? In the past, traditional open-chest and open-abdomen surgery took three hours because the incision took a long time to open and close. Laparoscopic surgery takes about an hour and a half to two hours, depending on the patient.