Final answer:
Hiatal hernia repair involves cutting the phrenoesophageal membrane and surrounding connective tissues to free and reposition the esophagus, followed by suturing the hernia wall closed.
Step-by-step explanation:
Hiatal hernia repair involves cutting the phrenoesophageal membrane and surrounding connective tissues circumferentially around the esophagus as far into the chest as possible. This step is critical to free the esophagus and allow it to be pulled back into the abdomen, thereby restoring its normal anatomical position. After the esophagus is repositioned, the surgeon will suture the wall of the hernia closed. This repair is typically done to prevent stomach acid from moving up into the esophagus due to the hernia, a condition known as gastroesophageal reflux disease (GERD).