ABSTRACT
Hiatal hernia and its symptoms became recognized during the initial half of the twentieth century. The deranged anatomy of the hiatus with protrusion of the stomach into the chest influenced surgeons to treat this condition and its associated reflux by restoration of the normal anatomy of the gastro-esophageal junction by operative techniques as proposed by Harrington, Sweet, Lertat, Jacob and Allison. Allison, however, documented that in a 20-year assessment of the patients he had treated, 49% showed an anatomical recurrence. Allison recognized that the reflux of gastric contents into the esophagus was responsible for the symptoms and he proposed the term reflux esophagitis. Woodward and Pope documented that approximately 50% of patients with an anatomical repair had pH documentation reflux after their operation.
