Fig. 1

Procedure of laparoscopic "tunnel" surgical approach. a Expose the hepatogastric ligament at the lesser curvature of the stomach. Incise an area on the hepatogastric ligament that is free of blood vessels, nerves, and adipose tissue. Anatomically, this area is devoid of nerve passage. b Incise the peritoneum at the outer edge of the right crus of the diaphragm, and bluntly dissect the loose tissue at the lower end of the esophagus to expose the junction of the left and right crus of the diaphragm. c Lift the gastroesophageal junction to further expose the left crus of the diaphragm. Thus, a "tunnel" is successfully created at the lower end of the esophagus. d Incise the phrenoesophageal ligament on the left side of the esophagogastric junction and connect the "tunnel". Further separate to the left along the fundus of the stomach, cut the gastrophrenic ligament until the upper pole of the spleen