Hiatal Hernia Repair
A hiatal (hiatus) hernia is where part of the stomach slides up through the opening in the diaphragm into the chest, which can cause acid reflux and other symptoms. Surgery pulls the stomach back into the abdomen, tightens the diaphragm opening, and often adds an anti-reflux wrap (fundoplication). It is usually done by keyhole (laparoscopic) or robotic surgery.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
The diaphragm has a small opening (the hiatus) through which the food pipe passes to reach the stomach. In a hiatal hernia, part of the stomach pushes up through this opening into the chest. Small hernias may cause no trouble, but larger ones — or those causing acid reflux that does not settle with medication — may need surgery. A large 'paraoesophageal' hernia is repaired to prevent complications.
The operation returns the stomach to the abdomen and narrows the widened opening in the diaphragm, usually reinforcing it. To control reflux, the surgeon often wraps the upper part of the stomach around the lower food pipe (a fundoplication). This is normally done through keyhole or robotic surgery using small incisions, which means less pain and a quicker recovery than open surgery. Assessment beforehand may include an endoscopy and tests of how the food pipe works.
For international patients, a coordinator arranges the evaluation and a transparent, itemized cost estimate before travel, and our surgeons can review your endoscopy and test results remotely. You receive clear guidance on the staged diet and recovery so your after-care can continue at home.
Who is a candidate?
- People with a large hiatal hernia, or one causing significant symptoms
- Those with acid reflux (GERD) that is not controlled by medication or lifestyle changes
- People who prefer surgery to taking long-term reflux medication, after discussion
- Patients with complications of reflux or a paraoesophageal hernia at risk of problems
- Those fit enough for surgery, as assessed by the surgical and anesthesia teams
What happens
- 1
Assessment
Tests such as an endoscopy, imaging and sometimes studies of how the food pipe moves and of acid levels confirm the hernia and reflux and help plan the operation.
- 2
Preparation
You meet the surgical and anesthesia teams and receive instructions on medicines and fasting, and on what to expect from the staged diet afterwards.
- 3
The operation
Under general anesthesia and usually through keyhole or robotic surgery, the stomach is returned to the abdomen, the diaphragm opening is narrowed, and an anti-reflux wrap (fundoplication) is often added.
- 4
Recovery and diet
You start with liquids and soft foods and gradually return to a normal diet over a few weeks. Your team guides the diet stages, and international patients receive a written after-care plan.
Benefits
- Relieves acid reflux and its symptoms, often reducing or stopping the need for reflux medicines
- Returns the stomach to its normal position and repairs the diaphragm
- Keyhole and robotic techniques mean small incisions, less pain and a quicker recovery
- Repairs large hernias that could otherwise cause complications
- Addresses the cause of reflux rather than only its symptoms
Risks & considerations
- Difficulty swallowing, which is usually temporary as the wrap settles
- Bloating or increased wind, and sometimes trouble belching, after a fundoplication
- The hernia or reflux can return over time in some people
- General risks of surgery and anesthesia, including bleeding and infection
- A need to follow the staged diet carefully during recovery
Conditions this treats
Where it is performed
This procedure is performed by our General Surgery Department.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Hiatal Hernia Repair — frequently asked questions
For many people, repairing a hiatal hernia with a fundoplication greatly improves or resolves reflux, and often reduces or stops the need for reflux medicines. Results are best in carefully selected patients, and your surgeon will discuss what you can realistically expect.
Usually, yes. Most hiatal hernia repairs are performed laparoscopically or robotically through several small incisions, which means less pain and a faster recovery than open surgery. Very large or complex hernias are occasionally repaired by open surgery.
The anti-reflux wrap and the repaired opening can make swallowing feel tight at first, which is why you start with liquids and soft foods and build up gradually. This usually settles over the first few weeks as the area heals; tell your team if it does not.
Yes. Our surgeons can review your endoscopy and test results remotely and advise whether surgery is appropriate and which approach suits you, before you decide to travel.
Hiatal hernia repair usually means one to three nights in hospital plus recovery, with a staged diet — your coordinator confirms the timeline. We provide a transparent, itemized estimate after reviewing your case and do not quote fixed prices online because each plan is individual.
Related treatments
Considering hiatal hernia repair?
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