For a study, the researchers sought to find how laparoscopic paraesophageal hernia repair (LPEHR) compared to mesh or primary repair. A thorough literature search was conducted to find RCTs comparing LPEHR with mesh repair to suture repair alone. The primary objectives for assessing efficacy were early (≤6 months) and late (>6months) recurrence rates. As secondary outcomes, intraoperative complications, total morbidity, and reoperation rates were employed to assess safety. A meta-analysis was conducted using relative risks (RR) for the investigated outcomes with 95% CI. The researchers looked at 7 RCTs that compared mesh (n=383) versus suture alone (n=352) repair. Early (RR = 0.74, 95% CI=0.26–2.07, P=0.46) and late (RR=0.75, 95% CI=0.27–2.08, P=0.48) recurrence rates were similar in patients undergoing LPEHR with mesh reinforcement and those undergoing primary repair. When stratifying the analysis by mesh type, similar recurrence rates were discovered (absorbable and nonabsorbable). Both groups had similar intraoperative complications (RR=1.03, 95% CI=0.33–3.28, P=0.92) and reoperation rates (RR=0.75, 95% CI=0.29–1.92, P=0.45). On the other hand, overall morbidity was greater following nonabsorbable mesh repair (RR=1.45, 95% CI=1.24–1.71, P<0.01). Regardless of the type of mesh used, patients undergoing LPEHR have identical early and late recurrence rates with mesh reinforcement or suture alone repair. Overall morbidity appears to be higher in people who have nonabsorbable mesh implants.