This study was to appraise safety and feasibility of laparoscopic approach and investigate the clinical effects of laparoscopic tension-free repair of esophageal hiatal hernia using mesh.From August 2006 to July 2009,24 patients with esophageal hiatal hernia underwent laparoscopic repair.Twenty-three patients received laparoscopic tension-free repair using mesh,at the same time,Toupet or Dor partial fundoplication was performed.One patient was converted to open surgery.The average operating time was 90 min (70-210 min) and the blood loss was between 10-110 mL.There was no death.The mean postoperative hospital stay was 5 days (3-30 days).During a follow-up period of 12-20 months (mean 15 months),there was no recurrence of the hernia,and no complication with use of mesh.The present study suggested that laparoscopic approach was secure and minimally invasive operation for esophageal hiatal hernia and the use of mesh could reduce recurrence rate.