The aim of this study is to find out if using a certain kind of mesh can reduce the chances of hiatal hernias coming back after anti-reflux surgery. The mesh used is approved by the U.S. Food and Drug Administration (FDA). 

Participants undergoing antireflux surgery will be assigned to one of two groups, a group that has surgery with mesh, or a group that has surgery without mesh. 

Any required post-surgical visits will be standard-of-care visits that participants would have regardless of study participation.