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Hiatal hernias are usually classified into three distinct types: type I, sliding hernias; type II, paraesophageal hernias; and type III, a combination of types I and II. Paraesophageal herniation is an uncommon disorder accounting for approximately 5% of all hernias at the esophageal hiatus. Laparoscopic repair of paraesophageal hernias is rapidly replacing the traditional open approach. However, several series have shown high recurrence rates due to the difficulty in closing the hiatal gap. A 28-year-old male patient presented with no symptoms including reflux symptom, but a herniation of the transverse colon and omentum into the thorax to the right side of the esophageal hiatus of the diaphragm was found. The anatomy of the stomach and small bowel loops were unremarkable. After reduction of the colon and omentum, the defect was closed and reinforced using Prolene mesh via a laparoscopic procedure. The patient recovered early, with no complication, and has been recurrence free during the 8 months of followed up. (J Korean Surg Soc 2005;69:485-487)
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