Miromatrix Biological Mesh for Hiatal Hernia Repair

Inclusion Criteria: * between 18 and 80 years old on the day of study enrollment * able and willing to sign the consent form and comply with all study visits and procedures * able to undergo elective laparoscopic hiatal hernia repair * free of cognitive or speech impairment * documented, symptomatic type II or III hernia ≥5cm in the axial/vertical dimension * commit to non-smoking for at least 4 weeks prior to procedure Exclusion Criteria: * previous operation of the esophagus or stomach * sensitivity to porcine material * pregnant or plan to be pregnant within next 2 years * immunocompromised or at risk of immunosuppression (i.e. be HIV positive, be experiencing organ rejection, be a recent or anticipated chemotherapy recipient) as determined by the Investigator * require emergent operation for acute gastric volvulus or strangulation * American Society of Anesthesiology (ASA) class 4 or greater * BMI ≥40 * life expectancy of less than 2 years at the time of enrollment * associated gastrointestinal disease that requires extensive medical or surgical intervention that might interfere with the quality of life assessment (e.g. Crohn's disease) * any condition in the opinion of the Investigator that would preclude the use of the study device, or preclude the subject from completing the follow-up requirements