Not really. If the hernia is very painful, you should have surgery.

If symptomatic to you AND no longer controlled by your meds, then it is time. Lap nissen are standardized procedures. Make sure the surgeon does at least two per week.

The short answer is yes. That is a moderate sized hernia and it will only get larger and more symptomatic as times goes on. I have unfortunately seen many patients who are told they have small hernias. 20 years later, those become large hernias and require emergency operations. I would recommend repair at this time. There are no other options for treatment.