In addition to esophageal hiatal hernia, there are many pediatric thoracoabdominal joint lesions that are good indications for laparoscopy, such as diaphragmatic pangenesis, thoracoabdominal hiatal hernia, pancreatic achalasia, and so on. Diaphragmatic pangenesis refers to the diaphragm congenital poor development, upward displacement, normal diaphragm top in 8-9 intercostal space, diaphragmatic pangenesis patients diaphragm top can reach 2-3 intercostal space, compression of lungs, abdominal organs upward, and torsion, the harm will be greater. Traditional open thoracic or open abdominal diaphragm folding surgery is difficult to reveal and more traumatic, while laparoscopy reveals clear, easy to reset the organs, reliable folding of the diaphragm under the mirror, can be continuous suture, or intermittent suture, which requires a high level of skill such as suture, knotting, and so on. Shandong University Qilu Hospital Pediatric Surgery Li Aiwu Thoracoabdominal hiatal hernia is generally open surgery, reveal also more difficult, while the mirror reveal clear, return abdominal organs after resection of the hernia sac, or from the neck of the hernia sac incision transverse, suture repair of the diaphragm can be, do not need to prevent reflux measures, the operation is relatively simple compared with the esophageal hiatal hernia. Pancreatic achalasia is a condition in which the gastric cardia and the upper esophageal end ring muscles are tense and cannot be relaxed, making swallowing difficult, dilating the upper esophagus, preventing the child from eating, and resulting in wasting and malnutrition. Treatment is transthoracic, or transabdominal incision of the lower esophagus and cardia ring muscle to relieve the obstruction. Surgical complications are susceptible to esophageal fistula due to easy rupture of the esophageal mucosa. Laparoscopic freeing of the esophagus and incision of the cricoid muscle layer is not only less traumatic, but also less likely to damage the esophageal mucosa due to the magnifying effect of the laparoscope. Moreover, the fundus of the stomach is sutured to the separated esophageal cricoid muscle layer microscopically to cover the esophageal mucosa, i.e., preventing esophageal fistula and strengthening the esophageal anti-reflux effect, which reduces the risk of the surgery in years. However, this step is difficult to operate in open thoracic, or open abdominal surgery due to the reason of exposure, and there is a risk of esophageal fistula or reflux when simply performing esophageal circumferential myotomy.