This is a case of a 59 year old man with a history of hiatal hernia repair and Nissen fundoplication performed twice in the past for reflux. He presents to our institution with recurrent reflux symptoms, including heartburn and regurgitation. Further medical management has failed. Pre-operative Upper GI swallow study shows a slippage of the Nissen fundoplication into the hiatus and recurrent reflux. DeMeester score is 28 on pH impedance test, confirming significant acid exposure of the distal esophagus. The decision was made to proceed with a robotic re-do hiatal hernia repair, Collis gastroplasty, and Nissen fundoplication. The Collis gastroplasty will extend the length of his intra-abdominal esophagus and allow for a tension-free fundoplication. Robotic ports were placed with an assistant port and the previous hiatal hernia repair and Nissen fundoplication were completely taken down. A 5 cm Collis gastroplasty was completed using the robotic stapler and a new Nissen fundoplication was created. The Upper GI swallow study performed post-op day 1 showed adequate neo-esophageal length without leak. The patient was discharged post-op day 2 tolerating a soft diet.