The use of meshes after repair of a Crural Defect is still under debate. In light of a recurrence rate up to 20% in larger defects, the augmentation of the hiatal closure with a mesh prosthesis seems to be advisable. However, severe complications due to mesh migration and erosion have been reported. GORE^® BIO-A^® Tissue Reinforcement is a three dimensional resorbable mesh which has demonstrated to be a ideal “scaffold” facilitating tissue generation and healing without the risk of a non-resorbable implant.