As you know, there are two major cavities in the human body, the thoracoabdominal cavity, which houses the respiratory/circulatory system and the digestive/exhaustive system, respectively, separated by the diaphragm. The passage of food into the stomach via the oral-esophageal route requires crossing the thoracoabdominal cavity, with a natural orifice in the diaphragm to accommodate the passage of the esophagus. Due to a defective congenital or acquired anatomical factor, the esophageal hiatus gradually enlarges, pushing intra-abdominal organs (mainly the stomach) into the thoracic cavity through the esophageal hiatus under higher abdominal pressure, and an esophageal hiatus hernia is formed. Esophageal hiatal hernia and reflux esophagitis are “difficult brothers and sisters”. Previously, they were often confused, but now they are recognized as the main anatomical factor in reflux esophagitis. Due to the presence of a hiatal hernia, the sphincter that acts as an anti-reflux barrier between the stomach and esophagus (i.e., the one-way valve that allows food to pass through) is damaged, and reflux esophagitis in these patients is often severe and difficult to control with medication; a large hiatal hernia often causes the entire stomach to flip into the chest cavity, and the patient not only has difficulty breathing, but the stomach itself may also bleed or even become necrotic. Foreign studies have shown that: 1. hiatal hernia is closely related to atypical hyperplasia and even cancer of Barrett’s esophagus and esophagus, and the incidence of these conditions is significantly higher in patients with hiatal hernia; 2. hiatal hernia severely damages the anti-reflux barrier of the esophagus, causing obvious symptoms of acid reflux and is not easy to control; 3. hiatal hernia affects the contouring function of the esophagus, and food and refluxed gastric acid accumulate in the hernia cavity and This aggravates the symptoms. Based on the above insights, surgery is required to repair the esophageal hiatus, restore its normal size, and rebuild the anti-reflux barrier. The surgery can be accompanied by a “collar” in the lower esophagus to further reduce acid reflux. A patch is also placed to reinforce the repaired esophageal fissure and prevent its recurrence, depending on the size of the fissure. Only through this surgical treatment (i.e. laparoscopic hiatus hernia repair + fundoplication) can patients with reflux esophagitis who have had little success with medication and have a very poor quality of life be cured.