In this video we present the case of a 43-year-old woman who previously underwent a laparoscopic type I hiatal hernia repair with bioabsorbable mesh and Nissen fundoplication. Following excellent symptom control, she presented six years later with worsening bloating and dysphagia. Work-up revealed transhiatal migration of an intact Nissen fundoplication. She was deemed a candidate for robotic-assisted paraesophageal hernia revision with Collis-type gastrectomy and Toupet fundoplication. This video highlights the challenges and technical aspects of robotic-assisted revisional foregut surgery and demonstrates strategies that may help prevent future recurrence such as bioabsorbable mesh reinforcement, esophageal lengthening via Collis-type gastrectomy, Toupet fundoplication, and anterior gastropexy. Dual console robotic technology also serves as an excellent learning environment to help familiarize surgical trainees with complex revisional surgery.