As long as you have the proper testing to determine whether or not you're a good candidate:
24hr PH monitor/BRAVO
...you'll do fine. The next thing you need to do to ensure a great outcome is to choose the right surgeon. This surgery isn't one that can be done with even a brilliant surgeon, if he/she hasn't had the amount of experience necessary to ensure a great wrap. Around here the rule of thumb is at least 300+ in a smaller city, and 1000+ in a larger city. If you call around to different GI docs in your area, try to get a read on who they're recommending. If you hear the same name over and over, that's the guy to go with.
When you have enough of your stomach herniated into your chest cavity it can cause some serious issues. The stomach can become strangulated, and tissue can die off. I don't think it's something that you can just leave alone. It can become even more herniated as well. There have been people in this forum whose stomach had herniated behind their heart. It's a much more difficult surgery if you wait it out and heaven forbid, it gets worse.
Here's a link with more information. You may have already seen it, but just in case you haven't...heartburn.about.com/od/hiatalhern2/a/paraesophhernia.htm
(If the link's not working right, just copy and paste it in your browser...it'll get you to the page. It worked when I first put it on the post, but now it's acting strangely.)
I had the surgery two years ago and am very glad I did. You can find some scary posts on the internet, but people here have a more balanced view of the surgery. I suspect that many of those people who are warning against the surgery did not have a skilled surgeon do the procedure.
Good luck with making the decision!
Post Edited (dencha) : 7/6/2011 9:17:30 PM (GMT-6)