MODERN SURGICAL MANAGEMENT OF HIATAL HERNIA: CURRENT TECHNIQUES, INDICATIONS, AND CLINICAL OUTCOMES

Abstract

Hiatal hernia is a common anatomical disorder characterized by displacement of the gastroesophageal junction and/or stomach through the esophageal hiatus of the diaphragm. Although many patients remain asymptomatic, clinically significant hiatal hernias ma y cause gastroesophageal reflux disease, dysphagia, regurgitation, respiratory symptoms, anemia, gastric volvulus, obstruction, and impaired quality of life. Surgical treatment has evolved substantially with the widespread adoption of laparoscopic and robotic techniques, improved understanding of esophageal length and crural tension, and increasing use of tailored antireflux procedures. Modern hiatal hernia surgery therefore requires individualized decision -making based on hernia type, symptoms, reflux status, esophageal motility, body habitus, tissue quality, previous operations, and surgeon expertise. Future research should focus on standardized definitions of recurrence, optimal mesh selection, tailored fundoplication, esophageal lengthening, robotic surgery, and long-term patient-reported outcomes.