DD minimally invasive technique for the treatment of esophageal hiatal hernia, parastomal hernia, obesity and type II diabetes mellitus. When it comes to “hernia”, the general public naturally understands it as a disease commonly known as “small intestine gas”. In fact, there are many types of medical “hernias”, including wall hernias and intra-abdominal hernias. Wall hernias include inguinal hernia (commonly known as “small bowel gas”), femoral hernia, incisional hernia, para-stoma hernia, white line hernia and semilunar hernia, while esophageal hiatal hernia is a type of intra-abdominal hernia. All of these hernias can cause various discomforts and affect normal life. Today, we will focus on parastomal hernia and esophageal hiatal hernia, which are also more dangerous for patients. Unfortunately, due to various reasons, the abdominal wall around the stoma can be damaged and the abdominal organs can then protrude under the skin of the abdomen to form a parastomal hernia. Parastomal hernias are the most common late complication of fistulotomy, occurring in approximately 10% to 25% of patients who undergo fistulotomy. Not only does a parastomal hernia make the abdomen very unsightly, but more importantly, patients who undergo fistula have closed devices to collect bowel contents or urine at the fistula opening, and a parastomal hernia prevents these devices from closing, resulting in repeated leakage of bowel contents or urine, which seriously affects the patient’s quality of life. In contrast, esophageal hiatal hernia is a disease that is not visible from the outside and is caused by the entry of intra-abdominal organs (mainly the stomach) into the thoracic cavity through the diaphragmatic esophageal hiatus, which means that part of the stomach that should be in the abdominal cavity has escaped into the thoracic cavity. Esophageal hiatal hernia is mainly caused by acquired factors such as obesity and chronic intra-abdominal pressure elevation, surgical and traumatic injury resulting in esophageal hiatus and weakness of the septal tissue around the hiatus. Esophageal hiatal hernia is often associated with gastroesophageal reflux disease, and therefore symptoms such as burning sensation behind the sternum or under the glabella, retrograde sensation of gastric contents, epigastric fullness, belching, and pain are present. The pain may radiate to the back, shoulders, and neck. In severe cases, bleeding may occur, and hernial sac impaction leads to sudden and severe epigastric pain with vomiting, complete inability to swallow or simultaneous hemorrhage, which can be life-threatening. Surgical repair of the defect is an effective treatment for various “hernia” conditions, and parastomal and esophageal hiatal hernias are no exception. Surgeons often find it difficult to treat parastomal hernias because of the high recurrence rate and postoperative complications associated with conventional open surgical treatment. The current application of laparoscopic techniques for the repair of parastomal hernias has greatly improved this situation, resulting in a lower recurrence rate, fewer complications, much less trauma, and better results with only three incisions of 5-10 mm. Traditional surgery for esophageal hiatal hernia often requires both open-heart and open-chest surgery, which is extremely traumatic. In contrast, laparoscopic esophageal hiatal hernia patch repair, which requires only three small incisions of 0.5~1cm, can repair the esophageal hiatal hernia or weakness through the placement of synthetic materials to achieve the treatment purpose with less trauma, less pain, faster recovery, and good efficacy at present. At present, the Department of Surgery of Huashan Hospital is in the leading position in minimally invasive surgical techniques for the treatment of para-stoma hernia and esophageal hiatal hernia, and has accumulated a lot of clinical experience. In order to better popularize the knowledge of disease treatment, Professor Yao Qiyuan, an expert in minimally invasive surgery, and his team will hold a charity clinic about para-stoma hernia and esophageal hiatal hernia in the morning of October 31 at Huashan Hospital to solve patients’ problems and answer their questions. With the development of economy and improvement of living standard, the number of obese people in China is also increasing. Obesity not only affects the beauty of the body, but more importantly, it can cause a variety of diseases, and the occurrence of type II diabetes is closely related to obesity. According to the estimation of the World Health Organization, the risk of type II diabetes in obese people is three times higher than that of normal people, and about 50% of obese people are at risk of diabetes, while 80% of type 2 diabetes patients are overweight or obese at the time of diagnosis. Type II diabetes is very dangerous and can cause extensive vasculopathy, which can involve almost all tissues and organs in the body, leading to dysfunction of some vital organs and making patients suffer from blindness, amputation or even death. Therefore, treating obesity can reduce the risk of developing type II diabetes, but the current traditional bariatric treatment methods are ineffective and have a high chance of regaining weight after treatment is stopped. The advent of bariatric surgery has greatly improved this situation, with good weight loss results that can be maintained over time. The results of a study published in the Journal of the American Medical Association also suggest that type II diabetes can be treated with weight loss surgery. In this study, 60 patients with severe obesity and diabetes were divided into a surgical treatment group and a conventional diabetes control treatment group. As a result, 73% of the patients in the surgical group had consistently normal blood glucose levels, much higher than in the latter group. Bariatric surgery is the reduction of gastric volume to achieve weight loss, and there are several surgical procedures: (1) adjustable gastric banding; (2) partial gastrectomy; (3) gastric bypass; and (4) biliopancreatic bypass and duodenal transposition. In today’s modern world, minimally invasive techniques in surgery have been rapidly developed and widely used, and this technique has also been applied to weight loss surgery. Compared to traditional open methods, laparoscopic bariatric surgery greatly reduces surgical trauma to the patient, and the advantages of rapid postoperative recovery, minimal discomfort and short hospital stay are very obvious. The results are also outstanding in the treatment of obesity and diabetes. In foreign countries, especially in Europe and the United States, laparoscopic bariatric surgery techniques have become more mature due to the high number of obese patients. The American Diabetes Association has formally incorporated bariatric surgery into the treatment protocol for diabetes. In recent years, with the increasing prominence of obesity and the limitations of conventional diabetes treatment in China, bariatric surgery has also gradually focused the attention of surgeons. Professor Yao Qiyuan of the Department of General Surgery of Huashan Hospital has been dedicated to clinical and scientific research of minimally invasive surgery for many years, and has accumulated rich experience in various minimally invasive surgeries, and has also carried out minimally invasive bariatric surgery. Therefore, this clinic will also start consultation activities on minimally invasive surgical treatment of obesity and diabetes.