To investigate the application of laparoscopic total left-side surgical approach (TLSA) in patients with hiatal hernia and gastroesophageal reflux disease, and to evaluate the short-term efficacy and safety of this surgical approach.

To retrospectively analyze the clinical data of 5 patients who underwent TLSA from June 2019 to September 2019 in Beijing Friendship Hospital and analyze the operation-related indicators, complications and quality of life score.

The median total operative time was 114 minutes, the patients' gastrointestinal function was recovery within 4 days and the average hospital stay was 3.8 days. No complications such as infection, bleeding, esophagus perforation and death occurred in the 5 patients. At six months postoperatively, gastroscopy reexamination showed their gastroesophageal flap valve are well established, the total score of Gerd-Q was 12.4 vs. 6.2, total esophageal acid exposure time was 3.48% vs. 0.38%. The incident of the dysphagia and flatulence were estimated by the EORTC QLQ-STO52 questionnaire decline with the time after the surgery.

TLSA has the advantages of broad surgical field, short surgical time and simple operation, especially suitable for elderly patients and patients with more underlying disease, and it has good short-term efficacy and safety.