Abstract
It is estimated that 15%–20% of the U.S. population have a hiatal hernia. 1 This incidence increases in people over the age of 50 years, with an estimated incidence of 60%. 2 The large prevalence of hiatal hernias can be explained by the natural tension at the diaphragm and the esophagogastric junction secondary to the pressure gradient between the thoracic and abdominal cavities. In addition, recurrent traction between the diaphragm and esophagogastric junction during respiration induces an inherent mechanical defect. As the incidence of hiatal hernias increases with the aging population, internists, gastroenterologists, and foregut surgeons must be familiar with all aspects of this disease.
Currently, there are several concepts regarding the management of hiatal hernias that remain elusive, including the decision to refer a patient to a foregut surgeon, causality between patient symptoms and their hiatal hernia, the proper surgical technique for hiatal hernia repair, and the management of recurrent hiatal hernias. In this special edition, we aim to provide guidance on many of the important topics surrounding foregut surgery. It is our hope that this special edition provides the reader with a summary of currently available literature on hiatal hernias and clarifies some of the considerations for the evaluation and treatment of hiatal hernias.