My 93yo father-in-law has had a hiatal hernia for years. He had an EGD last week confirming 3/4's of his stomach is in his chest. He had no twisting, erosion, ischemic changes. Family is to go to f/u visit to discuss treatment options.a I am a 40+yr RN newly retired. I would be agreeable to lap Nissen as his general physical condition is pretty good. He had a AAA REPAIR/bypass procedure 17 months ago and recovered well. What reason might an open procedure be recommended?