Summary Surgical reduction of a hiatal hernia including re-approximation of the diaphragmatic crura is a crucial component of the operative treatment of gastroesophageal reflux disease. It is one of several components of the restoration of the antireflux barrier to address the underlying alteration. After achievement of the required intraabdominal esophageal segment, tension-free closure of the dilated hiatus is essential for successful and durable repair. This re-approximation of the crural pillars represents an essential part of the surgical procedure and seems to have a greater impact on the compliance of the esophagogastric junction than sphincter augmentation. Therefore, particular attention must be paid to fulfilling the prerequisites for successful hiatal hernia repair.
Alexander M. Prusa (Fri,) studied this question.