Most surgeons believe that cruroplasty (hiatoplasty) is an essential part of antireflux operations. One of the main causes of failure after antireflux operations is gastric wrap herniation through the hiatus that may be attributed to a breakdown of the hiatal closure or to a faulty repair. In this lecture, Prof. Swanström discusses the diagnosis and treatment of short esophagus and the usefulness of mesh placement.