China was one of the first countries to successfully carry out surgical treatment of esophageal cancer. As early as the 1940s, Professor Wu Yingkai of the Union Medical College Hospital was the first to successfully complete a stage I resection anastomosis for esophageal cancer, and his remarkable contribution has been respected by his peers around the world. China is a large country of esophageal cancer, with the sixth highest mortality rate of all kinds of malignant tumors and hundreds of thousands of new cases every year. Meanwhile, China is also the country with the most completed esophagectomies in the world. However, for many years, esophagectomy has been mainly performed by left-sided open-chest or right-sided open-chest with large open-abdomen incision, which causes large incision, severe pain, slow postoperative recovery and many complications, causing great pain to patients and often leaving long-term incision pain and other sequelae. How to make the surgery minimally invasive and reduce the patient’s pain is an important topic of research for clinical scholars in surgery. The development of thoracoscopic technology, which appeared in the 1990s, has been able to complete most of the surgeries for chest diseases, but because of the many steps, complicated operation and time-consuming and laborious operation for esophageal cancer, it has been a forbidden area for minimally invasive surgery for a long time. Scholars from various countries have started to explore a safe and effective minimally invasive surgical method since the beginning of this century. In the beginning, thoracoscopy was only used to free the esophagus and remove lymph nodes, in conjunction with an open free stomach, and finally to perform an anastomosis of the esophagus and stomach in the chest or neck (Cuschieri 1992). This procedure is mainly used to replace the traditional three-incision open-chest step, which significantly reduces the pain of the thoracic incision and is a transitional technique for the eventual implementation of total lumpectomy esophagectomy. Since laparoscopic techniques are more mature compared to thoracoscopy and laparoscopic gastric cancer surgery has been successful in recent years, it would make more sense to replace abdominal surgery with laparoscopy. 77 cases of combined laparoscopic and thoracoscopic esophagectomy for esophageal cancer were first reported by Luketich in 2000, with no operative deaths and a significant reduction in postoperative pain and complication rates. The advantages of this procedure compared with traditional open surgery are: (1) minimally invasive, less painful, patients can get out of bed the next day and accelerate postoperative recovery; (2) less bleeding; (3) more thorough lymph node dissection; (4) lower postoperative complications; and (5) slightly lower total cost than open surgery due to faster postoperative recovery and shorter application time of antibiotics and expensive nutritional drugs. However, the disadvantages are: high technical requirements for the operator, long learning curve, longer operation time, and not suitable for those with larger tumors. The American Surgical Corporation (Convidien) has targeted the development of a thoracoscopic gastroesophageal anastomosis (Ovil system), which makes a full thoracoscopic gastroesophageal anastomosis (lumpectomy Ivor Lewis procedure) possible. At present, the true sense of total lumpectomy for esophageal cancer surgery mainly refers to the following two procedures: (1) thoracoscopic + laparoscopic + neck anastomosis (lumpectomy McKeown procedure); (2) thoracoscopic + laparoscopic intrathoracic anastomosis. Both are able to achieve complete clearance of the thoracic and abdominal lymph nodes. Since 2000, our center has taken the lead in exploring and succeeding in thoracoscopic free and resection of esophageal cancer, becoming one of the very few units in the city and even in the northern region that can perform this technique. After that, we sent our staff to the second largest medical center in the United States in 2010 to study laparoscopic and robotic surgery, and after returning to China, we successfully carried out full laparoscopic radical esophageal cancer surgery, which has completely solved this medical problem. At present, our center has routinely carried out total laparoscopic esophagectomy for early and mid-stage thoracic esophageal cancer. The postoperative pain is significantly reduced, and the patient can get out of bed the next day. With the further reform of Beijing’s medical insurance policy, disposable surgical instruments that used to be paid for by the patient can also be reimbursed by 70%, making the out-of-pocket ratio of this surgery significantly smaller, and the majority of patients are expected to receive the benefits of the new technology.