On May 19, 2014, I admitted a special female patient, said to be special because, firstly, she was older, 85 years old, which can be described as old age, secondly, she had severe curvature of the spine and could not lie flat as normal, and thirdly, she had persistent pain in the upper abdomen and behind the sternum, could not eat and vomited intermittently. After examination, the old man had a severe esophageal hiatal hernia and the whole stomach had entered the chest cavity. After conservative treatment, the above symptoms could not be relieved. The family was very anxious and approached me several times to discuss whether the problem could be solved surgically. On May 23, with the full support of the second department of anesthesia, my assistant and I performed laparoscopic esophageal hiatal hernia repair for the old man under general anesthesia. We first gave the patient a pneumoperitoneum with the abdominal pressure controlled at 10 mmHg, then punched five keyhole-like holes in the upper abdomen and inserted the laparoscope and surgical instruments deep into the abdominal cavity to see that the patient’s diaphragmatic fissure was wide open, just like a door, allowing the whole stomach to enter the chest cavity (see figure). After resetting the patient’s stomach, the ultrasonic knife was carefully used to free the esophageal fissure, the diaphragmatic foot and the surrounding adhesive band, and the entire lower end of the esophagus was completely freed and traction was applied upward, and the diaphragmatic foot on both sides was sutured so that the open esophageal hollow was reduced to pass through the esophagus only, and the operation was completed by fixing the stomach fundus and the diaphragm around the esophageal fissure. The whole operation went very smoothly and almost no bleeding was seen. The patient recovered well and was able to eat smoothly after the operation. Symptoms such as vomiting and pain disappeared and he was safely discharged from the hospital on the fourth day after the operation (May 27). Since the return visit, the old man is taking care of himself and his quality of life has improved significantly. Wang Ju, Department of General Surgery, People’s Hospital of Inner Mongolia Autonomous Region, said that hiatus hernia is a disease in which the intra-abdominal organs (mainly the stomach) split into the thoracic cavity through the diaphragmatic esophagus. Most esophageal hiatal hernias require surgical treatment. The traditional surgical approach is transthoracic or transabdominal open surgery, which is more invasive. In particular, transthoracic surgery is associated with heavy cardiopulmonary interference, high anesthesia requirements, and high postoperative complications. Although transabdominal surgery is less disturbing to the heart and lungs, it is more traumatic due to the larger incision, and it is difficult to obtain a good exposure due to the small space, which makes the operation more difficult. In contrast, with laparoscopic surgery, only 4-5 operating holes about 0.5~25px long are established in the upper abdomen, the esophageal fissure is exposed free, the fundus is reduced into the abdominal cavity, and both diaphragmatic feet are intermittently sutured below the esophagus to narrow the esophageal fissure. For larger esophageal fissures, patch repair is often required. After the repair of the fissure is completed, the fundus is then folded to prevent esophageal reflux. In developed countries, laparoscopic esophageal hiatal hernia repair and fundoplication has been regarded as the gold standard for the treatment of esophageal hiatal hernia. We will vigorously develop this technology to provide safe, standardized and minimally invasive medical services to more patients!