Introduction: Minimally invasive esophagectomy (MIE) is a complex operation often associated with a variety of complications. The incidence varies widely in the literature between 0.7%-14%, and if often misdiagnosed or undiagnosed [1, 2]. Hiatal hernia following esophagectomy is an unusual complication, that can be treated laparoscopically. Methods: A 59 year-old male with a history of a T2N2 esophageal adenocarcinoma treated with neoadjuvant chemotherapy and radiation presented as an outpatient eight months after minimally invasive esophagectomy with complaints of persistent chest pain. CT scan demonstrated a large hiatal hernia containing loops of jejunum as well as transverse colon. The patient was scheduled for elective repair. Results: The procedure was completed laparoscopically. There were no intraoperative complications, or conversion to an open procedure. Patients was initiated on oral diet on post-operative day #0. Patient was discharged to home on POD#1. Conclusion: Hiatal hernia following esophagectomy can be associated with an increased risk of incarceration or strangulation. Repair can be accomplished with low mortality; and laparoscopic surgical management is recommended. References:

1. Kent MS, Luketich JD, Tsai W, Churilla P, Federle M, Landreneau R, Alvelo-Rivera M, Schuchert M. Revisional surgery after esoph- agectomy: an analysis of 43 patients. The Annals of thoracic sur- gery. 2008;86:975-983; discussion 967-974.
2. Crespin, O., Farjah, F., Cuevas, C., Armstrong, A., Kim, B., Martin, A., ? Oelschlager, B. (2016). Hiatal Herniation After Transhiatal Esophagectomy: an Underreported Complication. Journal of Gastrointestinal Surgery, 20(2), 231-236. https://doi.org/10.1007/s11605-015-3033-7