Esophageal hiatal hernia refers to the relaxation and enlargement of the esophageal hiatus caused by various reasons, resulting in part of the stomach tissue or other abdominal organs through the diaphragm through the esophageal hiatus into the thoracic cavity, most commonly seen in patients over 40 years of age. Symptoms] The symptoms of esophageal hiatal hernia are mainly chest pain, swallowing pain with dysphagia, which can be accompanied by reflux and burning sensation at the back of the sternum and the back, and can be diagnosed by the following tests. Zhao Hongzhi, Minimally Invasive Surgery Center, Nankai Hospital, Tianjin 1. X-ray barium meal examination is the main method of diagnosing esophageal hiatal hernia. During the examination, it should be observed how the position of cardia and stomach changes and the degree of reflux when lying down and epigastric pressure is applied.2. Endoscopy shows that the dentate line is shifted upward, and the hernia sac can be seen between the level of the hiatus.3. Esophageal manometry and pH monitoring: the characteristic bimodal high-pressure bands can be detected in the case of a hiatus hernia of the sliding esophagus. The hiatus hernia can be divided into three types: type I is a sliding hiatus hernia: the gastroesophageal junction enters the mediastinum through the hiatus when the patient is lying down or in the head-down position, and it can be self-contained when the patient’s position is changed. type II is a paraesophageal hiatus hernia: the gastroesophageal junction is normal, and part of the stomach enters the thoracic cavity. type III is a mixed hiatus hernia: the two conditions of type I and II exist at the same time. The current view is that minimally invasive treatment for combined reflux esophagitis or giant esophageal hiatal hernia is internationally recognized as the gold standard, which can achieve the effect once and for all and avoid long-term medication. In our minimally invasive surgery center, laparoscopic esophageal hiatal hernia repair + fundoplication has achieved excellent results. Previously, conservative treatment was usually the mainstay to prevent gastroesophageal reflux, promote gastric emptying, protect the esophageal mucosa, and improve the patient’s quality of life.1. Adjust the living and eating habits . Avoid eating stimulating food, small amount of meals, high protein and low fat is appropriate, avoid bending and lying down after meals, appropriate light activities, and actively treat the triggers of increased intra-abdominal pressure, such as constipation, cough, obesity, etc. 2.Drug therapy H2 receptor blocker, PPI can effectively control the reflux symptoms of the patient, and if necessary, add the upper gastrointestinal tract dynamics of the drug.