HighlightsHiatal hernia can be diagnosed by various modalities. Only investigations which will alter the clinical management of the patient should be performed.Repair of a type I hernia in the absence of reflux disease is not necessary.All symptomatic paraesophageal hiatal hernias should be repaired, particularly those with acute obstructive symptoms or which have undergone volvulus.Laparoscopic hiatal hernia repair is as effective as open transabdominal repair, with a reduced rate of perioperative morbidity and with shorter hospital stays. It is the preferred approach for the majority of hiatal hernias.
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