ESOPHAGEAL hiatus hernia is a clinically demonstrable lesion more frequently than may be generally realized. Schatzke1 stated that by using greater than normal intra-abdominal pressure during fluoroscopic examination, hiatus hernia can be demonstrated in 70% of patients over 60 years of age. Most of these lesions are asymptomatic, and most of those with mild symptoms may respond to conservative therapy. A few, however, may be attended by symptoms and signs sufficiently grave to demand surgical intervention.
The repair of hiatus hernia may not be a simple procedure; moreover, the rate of recurrence following conventional techniques is almost prohibitive. Soutter,2 for instance, in analyzing the results of hiatus hernia repair at Massachusetts General Hospital found a recurrence rate of 14% following the transthoracic approach and a rate in excess of 40% in those patients treated by the abdominal route. One of us had the disconcerting experience of having seen