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A hiatus hernia occurs when part of the stomach slips up through the diaphragm into the chest. It is common in obese patients and will probably have been noted during Gastroscopy. At the time of bariatric surgery your hiatus hernia may be repaired with simple sutures to the hiatus. Generally the symptoms associated with a hiatus hernia like heartburn and reflux respond best to weight loss rather than anti-reflux surgery.