Since the first laparoscopic surgical repair of a diaphragmatic hernia in 1991, there has been debate about the best approach to treating a hiatal hernia. It is suggested that the laparoscopic approach, with many types of surgery, has a low postoperative pain rate, fast recovery time.

"HIS angle" refers to a normal acute angle formed between the abdominal esophagus and the fundus of the stomach (large bulge or fundus) at the gastroesophageal junction (esophagogastric junction). This angle is one of the important factors in preventing gastroesophageal reflux disease. When the fundus is enlarged by air or other gastric contents, the thoracic esophageal structures are "pushed" from left to right, closing the gastroesophageal flap valve.