Hiatal hernias are found in approximately 40% of patients undergoing bariatric surgery. The esophagus is a muscular tube which connects the mouth to the stomach. This esophagus tube must travel through a large sheet of muscle (the diaphragm) that separates the chest cavity (heart and lungs) from the abdominal cavity (stomach and organs). There is a small circular opening in the back of the diaphragm near the spine through which the esophagus passes through. If the opening in the diaphragm for the esophagus is too large, this is known as a hiatal hernia. It’s not something you can see or touch yourself – don’t confuse a hiatal hernia with a hernia on your abdomen. These are called ventral, incisional or inguinal hernias. At the time of your bariatric surgery, Dr. Weiss will assess the size of the esophageal opening in your diaphragm and tighten it if necessary (a hiatal hernia repair). This adds only about 15 minutes to your operative time and doesn’t affect your weight loss results, amount of pain, or recovery time.