Minimally invasive surgery for esophageal cancer is a new surgical method relative to traditional open surgery, which came into being with the improvement of surgical technology and equipment. In the past, when doing thoracic surgery, especially esophageal surgery, it was necessary to make a 20 to 30 centimeter long incision, and use a spreader to spread the ribs, so that the surgeon could look at the organs in the body directly to complete the surgery. However, this type of surgery can cause serious damage to the patient, especially when the ribs are spread out, which can damage the normal bony structure of the thorax. Patients are prone to postoperative pain, discomfort, and prolonged recovery time, among many other problems, while these discomforts may increase the risk of other pulmonary complications. Nowadays, minimally invasive surgery does not need to open up the ribs, but only makes a few very small incisions on the surface of the body, each of which is about one or two centimeters long. A camera is used to look inside the chest cavity, and surgical instruments are guided through the small incisions to complete the surgery. For the patient, the level of trauma is much lower than before. Minimally invasive surgery for esophageal cancer covers two parts. For very early-stage lesions, endoscopic treatment is sufficient, but the percentage of patients in this group is very small. Because the chance of detecting early esophageal cancer is very low, the minimally invasive treatment we are talking about now refers more to minimally invasive surgical procedures. The operation process of minimally invasive surgery is largely the same as traditional open surgery. First, general anesthesia is administered, and then four puncture points are selected in the patient’s chest. The first is the puncture point where the camera enters, and once the puncture is complete the camera is extended into the chest cavity to explore the condition of the chest cavity. If there is no problem and it is suitable for minimally invasive surgery, we will then puncture the other three operating holes and extend the surgical instruments into the chest cavity to complete the tumor removal. Of course, this is only part of the surgery. Esophageal cancer surgery is the most complicated and longest type of thoracic surgery. It is mainly because the surgery is not only to remove the tumor, but also to reconstruct the digestive tract in order to finally complete all the processes of minimally invasive surgery for esophageal cancer. I. Will it be more difficult to do digestive tract reconstruction in minimally invasive surgery? Nowadays, there are two ways to do digestive tract reconstruction in minimally invasive esophageal surgery: one is to anastomose directly in the chest cavity, which needs to be done with the assistance of laparoscopy, and the doctor needs to go through special technical training; nowadays, the operation technology is very mature, so there is not much problem. Another way is to lift the stomach upward and pull it to the neck, make a small incision of 5-8 centimeters in the neck, and complete the anastomosis between the esophagus and the stomach under the direct vision through this small incision; this is the anastomosis completed under the open state, so there is no problem in the technology. Second, what are the advantages of minimally invasive surgery compared with traditional open heart surgery? At present, there are a lot of researches at home and abroad about the comparison between minimally invasive surgery and open surgery, and basically some consensus has been formed: 1. Compared with traditional open surgery, minimally invasive surgery can enable patients to get a better and faster postoperative recovery; 2. It can reduce the chances of the patients’ postoperative complications such as respiratory insufficiency. Respiratory insufficiency is a more serious adverse consequence caused by esophageal cancer surgery, and now many studies have confirmed that the chances of pulmonary complications after minimally invasive surgery are significantly reduced; 3. It can improve the patients’ long-term quality of survival, including the long-term pain and the feeling of physical discomfort after surgery. In addition, a very important advantage of minimally invasive surgery is the aesthetic appearance of the incision. If we make a 30-centimeter-long incision in the chest, it is still very destructive to the entire chest wall structure, and it is not particularly desirable in terms of form and appearance. If we do it through four 1-centimeter incisions, the patient will look and feel much better.