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The management of paraesophageal hernia is one of the most discussed topics in surgical forums. Most surgeons currently take a laparoscopic approach with the excision of the sac and the addition of an anti-reflux procedure to treat coexistent reflux. A total fundoplication (Nissen Fundoplication) is the preferred approach to patients with gastroesophageal reflux as it provides better control of the reflux compared to partial fundoplications. Whether placement of a mesh is necessary or not is still under debate.
