Use of Strattice Mesh in Paraesophageal Hernia Surgery

Inclusion Criteria: * Documented symptomatic paraesophageal hernia. * Greater than 5 cm hiatal hernia on upper gastrointestinal study. * Evidence that the stomach or other viscera is present in the hernia and does not spontaneously reduce from the mediastinum. * Significant symptoms or signs of a paraesophageal hernia including but not limited to heartburn, dysphagia, chest pain, shortness of breath, postprandial abdominal pain, early satiety, odynophagia, or chronic anemia. * Consenting adult 19 years of age or older * Must be able to participate in follow-up evaluation. * Free of cognitive impairment Exclusion Criteria: * Children and adolescents (19 years of age or younger). * Pregnant and breast feeding patients. * Vulnerable subjects such as pregnant women, children less than 19 years age, and decisionally impaired persons. * Patients with previous operation of the esophagus or stomach. * Patients with associated gastrointestinal diseases that require extensive medical or surgical intervention that might interfere with quality of life assessment (e.g. Crohn's disease). * Patients with emergent operation for acute gastric volvulus. * Patients with known sensitivity to porcine material.