China accounts for 20% of the world’s population, but has more than 50% of the world’s esophageal cancer patients, and more than half of the world’s patients die of esophageal cancer. The incidence rate of esophageal cancer in China is more than 7 times of the global average, and the incidence rate is the fourth among all kinds of malignant tumors in men and the seventh in women, while the mortality rate is the fourth among both men and women. The cruel fact warns us that the prevention and treatment of esophageal cancer in China should not be delayed. The high incidence areas of esophageal cancer in China are North China, North Jiangsu, East Zhejiang, Fujian-Ganxi and Chaoshan Hakka area in Guangdong. In the early stage of esophageal cancer, patients basically do not have any discomfort. With the development of the disease and the expansion of the tumor, patients can gradually develop abnormal sensation. At the beginning, it is not easy for patients to pay attention to such sensation because it does not affect their life and living. The esophagus is the channel for eating, so when the tumor increases, the first thing is to hinder eating. Once the patient feels difficulty in swallowing, most of them are in the middle and late stage of cancer. Modern people live a stressful life and often gobble up their meals, so they often think that they are eating too fast and do not care about the swallowing discomfort. At the same time, due to air pollution and mental tension at work, many people suffer from chronic pharyngitis and are more likely to ignore the discomfort in the throat. According to the census data, the following points may be the early symptoms of esophageal cancer: 1. Posterior sternal distension or slight pain. This symptom does not occur continuously, but intermittently or worsens after exertion and when eating rapidly. This is because the esophagus itself is peristaltic at any time, and the symptoms will appear only when the peristaltic movement reaches the lesion site. 2. Foreign body sensation when swallowing food. During swallowing, food (especially dry and hard food) passing through the lesion area (the lesion is very small) may produce a foreign body sensation, and it is often fixed in one area, and some patients describe the feeling of having something that can never be swallowed. It is easy to be neglected by patients because the symptoms are mild and occur intermittently. 3.Sensation of stagnation or stuttering in swallowing, i.e., the patient seems to have a feeling of stagnation and stuttering in a certain area when swallowing food, which is also not continuous and only gradually becomes obvious after the development of the lesion. 4. A feeling of chest distension or constriction, often accompanied by a feeling of dryness in the throat. Patients complain of a kind of stuffy phenomenon in the front of the chest all the time, as if there is an object blockage, so that the chest is tight feeling, especially obvious when swallowing food, but does not affect normal life and work. The above early symptoms usually last for more than 3 months, and are no longer early when they occur frequently and persistently and worsen. Nowadays, many hospitals are offering painless gastroscopy, which is painless and convenient. The cause of esophageal cancer is still unclear, mainly some factors that increase esophageal damage can cause esophageal cancer, in Guangdong, many people love to drink kung fu tea, very hot and very strong tea, the tea cup in the hand can not stand, but to drink a mouthful, the esophageal mucosa will be easily scalded, if you keep drinking, and then scalded again, it will cause ulcers, which may lead to cancer. Some regions love to eat pickled food or kimchi pickles, which contain a large amount of nitrosamines, which are also the main cause of cancer. Compared with minimally invasive lung surgery, minimally invasive esophageal cancer surgery is slow in China, because on the one hand, it is complicated, involving resection of the diseased esophagus and reconstruction of the esophagus, and on the other hand, minimally invasive esophageal cancer surgery involves three regions: chest, abdomen and neck, and the thoracic surgeons who perform the surgery are not familiar enough with abdominal anatomy and lack the courage to perform lumpectomy. Another important reason is that esophageal cancer is a “poor cancer”, that is to say, most of the patients with esophageal cancer are people with poor living and economic conditions, and the instruments used in minimally invasive surgery, especially the imported instruments with good results, are not reimbursable at present, and the domestic prices of similar products are several times of the prices in developed countries, which is more than confusing. This is not only confusing to our mainland doctors, but also to doctors from developed countries and regions who have heard about it. The cost of minimally invasive esophageal cancer surgery is RMB 6,150 and RMB 8,200 respectively, depending on the surgical method, and the surgery requires 3-5 doctors. However, the cost of using imported surgical instruments during the operation is 20-30 thousand RMB. In developed countries and regions such as the United States, the two figures are reversed, meaning that the cost of the surgeon’s operation is about $30,000, while the cost of the same instrumentation is less than $2,000. But no matter what, minimally invasive surgery is the development trend. Our department now does esophageal cancer, which has been reduced from a large incision of nearly 40cm to a minimally invasive incision of 4-5cm, and with the help of thoracoscopy, the lesion is removed more completely. Patients recovered faster after surgery. By using domestic instruments during the surgery, we try to save the cost for the patients.