Randomized, Prospective Controlled Trial of Paraesophageal Hernia Repair With Small Intestinal Submucosa (SIS)

Inclusion Criteria: * Age \> 18 years * Documented symptomatic paraesophageal hernia * Ability to participate in follow-up evaluation * Has a telephone * Free of cognitive or speech impairment Exclusion Criteria: * Patients requiring intra-operative conversion to an open procedure * Unable to close the crura primarily * Short esophagus that requires the surgeon to perform a lengthening procedure * Previous operation of the esphagus or stomach * Associated gastrointestinal diseases that require extensive medical or surgical intervention that might interfere with quality of like assessment * Intraoperative full-thickness perforation of the esophagus * Emergent operation for acute volvulus * Ineffective peristalsis defined as average amplitude of peristalsis less than 30 mmHg or \< 70% propagation of peristaltic waves in the distal esophagus