The question of surgical treatment of the hiatus hernia and GERD is very relevant till that very time. The choice of the optimal method of surgery is not definitively determined, the question of indications for the use of implants in hiatus hernia repair also remains open. Material and methods. In the presented article, the results of treatment of 86 patients with hiatus hernia performed with the modified procedure laparoscopic Nissen fundoplication. Choosing the tip of hiatus repair and the need for a mesh implant, based on determining the degree of diaphragm dystrophy and hiatus data from computed tomography. The efficacy outcome measures were relief from GERD symptoms, as measured according to the Gerd-Q, SF-36 and GSRS scale and hiatal hernia recurrence. Results. A statistically significant reduction in the reflux syndrome according to the Gerd-Q and GSRS and a decrease in the dyspeptic syndrome were revealed, as well as an improvement in the quality of life, according to the SF-36. Results of the treatment: from 86 patients good results were noted in 81 cases, satisfactory in 5 cases, no unsatisfactory result registered. Conclusion. The results obtained in the course of the work make it possible to conclude that the developed method can be recommended for practical use. which is confirmed by the results of the treatment.