RT Book, Section A1 Odell, David D. A1 Gangadharan, Sidhu P. A1 DeCamp, Malcolm M. A2 Sugarbaker, David J. A2 Bueno, Raphael A2 Burt, Bryan M. A2 Groth, Shawn S. A2 Loor, Gabriel A2 Wolf, Andrea S. A2 Williams, Marcia A2 Adams, Ann SR Print(0) ID 1170407726 T1 Belsey–Mark IV Fundoplication/Collis Gastroplasty T2 Sugarbaker’s Adult Chest Surgery, 3e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781260026931 LK accesssurgery.mhmedical.com/content.aspx?aid=1170407726 RD 2024/10/04 AB The management of gastroesophageal reflux disease (GERD) and hiatal hernia has evolved in both general and thoracic surgery over the course of the past century. The advent of H2 blockers and proton pump inhibitors (PPIs) markedly improved options for medical management and reduced the number of patients presenting to the surgeon. However, a well-defined role for surgical treatment remains in the circumstances of medical failure or medication intolerance, as well as for a fixed anatomic abnormality such as a larger hiatal hernia. Beginning in the late 1950s with the work of Belsey, Nissen, Hill, and Collis and extending through the present day, the optimal surgical approach to reflux disease and repair of paraesophageal hernia has been a topic of debate among surgeons. In the modern era, minimally invasive approaches (predominantly laparoscopy) have become the mainstay of surgical treatment for both GERD and hiatal hernia. However, the traditional techniques of open hiatal hernia repair and fundoplication are required in select patient groups. This chapter discusses the current application of the transthoracic Collis–Belsey approach to hiatal hernia repair with a focus on appropriate patient selection and evaluation.