With the rising incidence of hiatal hernia and gastroesophageal reflux disease, surgical techniques urgently require refinement to improve patient outcomes. Guided by the concept of "anatomical priority", Professor Chen Shuang's team has established a standardized seven-step laparoscopic protocol, emphasizing three key components: precise dissection of the "sacred plane", three-dimensional crural reconstruction, and tension-controlled fundoplication. To address limitations such as restricted intraoperative visualization and poor reproducibility, the team further developed the innovative "necktie traction technique". This method employs a red pediatric catheter to create a dynamic traction system, enabling directional field exposure, axial esophageal repositioning, and quantitative control of fundoplication. Integrating biomechanical principles, the technique provides a visualized and standardized operative pathway, significantly enhancing surgical safety, efficacy, and reproducibility. As a novel approach combining anatomical restoration with functional anti-reflux reconstruction, the "necktie technique" offers robust technical support for the standardized promotion of laparoscopic anti-reflux surgery.