How is a hiatal hernia repaired?

Laparoscopic Surgery. A hiatal hernia is an enlargement of the normal hole in the diaphragm muscle thru which the esophagus passes to enter into the abdomen. A hiatal hernia may lead to gerd by virtue of the stomach yo-yo-ing up thru the hiatus into the chest. Surgical repair involves three key steps: return the stomach to the abdominal cavity, tighten the hole in the diaphragm, and create a new valve to rx reflux.
See below. Hiatal hernia surgery is almost always done laparoscopically with a few small trocar incisions. The stomach and some esophagus are brought back down into the abdomen. The diaphragmatic crura are sutured together. Sometimes this is reinforced with a prosthetic. Usually an anti reflux procedure like Nissen fundoplication is done as well. The fundus may be sutured to the crural repair also.
Sutures. Usually the stretched out opening the the diaphragm that the esophagus passes through (hiatal hernia) is repaired laparoscopically with sutures. Occasionally mesh is used, but that is controversial. Make sure your surgeon has experience with hiatal hernia repair - many don't, and it is a difficult operation.