Hiatal hernias range from small sliding hernias associated with reflux to large paraesophageal hernias that can cause obstruction, bleeding, or volvulus.
Repair involves reduction of the hernia, restoration of anatomy, and reinforcement of the hiatus. Robotic approaches allow precise mediastinal dissection and tension-free reconstruction.
Large paraesophageal hernias can significantly impact pulmonary function and nutrition. Surgical correction often improves both.
Each repair must be individualized. Decisions regarding mesh reinforcement, fundoplication type, and approach depend on patient anatomy and physiology.
Thoughtful technique determines durability.
