At what point does a hiatal hernia need repair? is it worth getting done because i've met my insur deductible? also have gerd controlled by meds.

Hiatal hernia repair: usually needs to be done when the GERD is uncontrolled or there is Barretts Esophagus. Then a repair may be beneficial. You should check with your gastroenterologist to see if it would be right for you.

Hiatal hernia: I assume you have had a hiatal hernia confirmed by imaging studies and not just presumed. As long as your GERD symptoms are well controlled, no reason to worry. Way before you think about "hiatal hernia" repair, you would benefit more from medically supervised weight loss. Your obesity is contributing to your "hiatal hernia".

Repair likely needed: Presence of hiatal hernia along with GERD symptoms is a good enough reason to get it repaired however decision to perform a surgical intervention depends on many factors including overall health, endoscopy findings and results of other investigations. A timely evaluation by a surgeon with experience in laparoscopic repair is a good idea.