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A hiatal hernia is when the top of the stomach gets displaced or herniates through the diaphragm and up into the chest cavity. Although most people with a hiatal hernia do not experience any symptoms, others may suffer from recurrent symptomatic reflux requiring medication or even surgery. Surgical repair essentially involves pulling the stomach back into normal position fully below the diaphragm and making the opening in the diaphragm smaller. A mesh is then placed over the incision to reinforce the closure to minimize risk of hiatal hernia recurrence. A hiatal hernia repair is often performed in combination with some variation of fundoplication whether Nissen or Toupet to further control severe reflux. In some cases, hiatal hernia surgery can also be combined with weight-loss surgery such as a sleeve gastrectomy.