My sleeve surgery is cancelled, but I can have RNY. The RNY is the best route for a mid to large hiatal hernia. This is what I've learned: with a 4cm hernia, the typical repair that comes with a sleeve is often inadequate. Under the pressure of the sleeve, the hernia often returns and GERD is worse than ever and can be a life changer toward the negative. With a 4 cm hernia, a patient is better to go the RNY route for a host of very good reasons: the nature of the procedure itself pulls the stomach pouch down, thereby putting the esophagus and upper stomach back into proper position; the hernia opening is fixed; the pouch of RNY is not under pressure, a greater greater greater chance the hernia will never resurface and the GERD is cured. At my original post, I was upset because I did not know I still had options and I was uneducated on the physiology of the RNY, having focused Dooley on the sleeve. My surgery date of December 26th still stands, just a different procedure. I believe I'm in the best of health. [emoji4]