Concierge upper GI · UK
Private anti-reflux surgery in the UK, by a consultant upper GI surgeon.
Fundoplication, LINX and hiatus hernia repair — properly worked up with manometry and 24-hour pH-impedance first, and matched to the operation that actually fits your oesophagus.
Why patients choose us
- 01
An upper GI consultant, in a proper unit
Anti-reflux surgery belongs in a specialist upper GI unit — a named consultant who does this operation weekly, not a general list.
- 02
Manometry and pH studies first, always
No wrap without objective evidence. High-resolution manometry and 24-hour pH-impedance off PPI are non-negotiable before we book you in.
- 03
The right operation, honestly
Nissen, Toupet, LINX, hiatus repair or a bypass in the right patient — we set out the trade-offs before you commit to any of them.
Indicative pricing
What private anti-reflux surgery costs in the UK.
Indicative ranges across our specialist upper GI network. Send the details and we quote firm figures across two or three options.
In short
A laparoscopic fundoplication in our network: £8,000–£12,000, home in one to two nights.
| Procedure | Indicative range | Typical duration | Stay / recovery |
|---|---|---|---|
| Laparoscopic Nissen fundoplication | £8,000–£12,000 | 90–120 min | 1–2 nights |
| Laparoscopic Toupet (270°) fundoplication | £8,000–£12,000 | 90–120 min | 1–2 nights |
| LINX magnetic sphincter augmentation | £12,000–£18,000 | 60–90 min | 1 night |
| Large hiatus hernia repair (± mesh) | £10,000–£16,000 | 120–180 min | 2–3 nights |
| Redo fundoplication (specialist) | £14,000–£20,000 | 150–210 min | 2–3 nights |
| Roux-en-Y gastric bypass for GORD + BMI >35 | £13,000–£18,000 | 120–150 min | 2 nights |
| Pre-op work-up (OGD + HRM + pH-impedance) | £1,800–£2,800 | Half-day x2 | 2 weeks |
| Consultant consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by which consultant does the case, by the operation chosen, by whether mesh or a LINX device is used, and by length of stay. We come back with a firm quote within one working day.
The problem
The right work-up, the right operation, the right surgeon.
Anti-reflux surgery is one of the easiest operations to get wrong — a wrap on the wrong oesophagus, or a LINX in the wrong patient, and life gets worse, not better. We fix that upstream.
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Manometry done properly
High-resolution manometry decides whether a full or partial wrap fits your oesophagus — we insist on it before booking.
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pH-impedance off PPI
A 24-hour pH-impedance study performed off PPI is what proves reflux exists — not the symptoms alone.
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A specialist upper GI unit
A consultant who does anti-reflux weekly, in a unit set up for it — not on a general operating list.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the manometry, the pH work-up, and the diet ladder afterwards.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · On the day
One to two nights in hospital
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Reflux history, PPI response, regurgitation, cough or asthma, hernia on any past scan.
- 02
Before
We recommend the work-up
Within one working day: which tests you actually need — OGD, high-resolution manometry, 24h pH-impedance off PPI, gastric emptying if indicated.
- 03
Before
Consultant review of the results
An upper GI consultant reads the manometry and pH data with you and sets out which operation fits — or whether surgery is not the answer at all.
- 04
On the day
Admission and anaesthetic
General anaesthetic in a specialist upper GI theatre. Laparoscopic or robotic — five small ports, no big cut.
- 05
On the day
The operation itself
60 to 120 minutes: hiatus repair, mobilisation of the fundus, and the wrap — Nissen, Toupet or LINX according to plan.
- 06
On the day
Overnight stay
One to two nights in hospital. Liquids the same evening if comfortable, no routine drains, and home on day one or two.
- 07
After
Diet progression and PPI wean
Liquids, then soft, then normal texture over three to four weeks. Most patients stop PPIs within two to four weeks. A review at six weeks.
Typical end-to-end: 4–6 weeks from enquiry to operation. Full recovery: 6–8 weeks.
When it helps
When anti-reflux surgery is the right step.
The situations where surgery earns its place — plus the red flag that means urgent OGD, not an anti-reflux booking.
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PPI-refractory typical reflux
Heartburn and regurgitation that persist despite a proper trial of a proton pump inhibitor, with pathological acid exposure on a 24-hour pH study off PPI.
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Volume regurgitation
Food or bitter fluid coming back into the throat or mouth — the symptom PPIs help least, and the one surgery helps most.
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Extra-oesophageal symptoms
Chronic cough, asthma or laryngitis with objective reflux on testing — surgery can help when the link is proven.
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PPI intolerance or preference
Side effects, drug interactions, or a wish to come off lifelong medication — a legitimate reason for surgery in the right patient.
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Large hiatus hernia
Type II–IV para-oesophageal hernias with symptoms, obstruction or volvulus risk — repair with cruroplasty ± mesh and a fundoplication.
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Barrett’s oesophagus with reflux
Barrett’s with ongoing acid exposure — surgery may slow progression and is discussed alongside surveillance.
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BMI over 35 with GORD
A Roux-en-Y gastric bypass outperforms fundoplication for reflux in this group — dual benefit for weight and reflux.
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Red flag: dysphagia or weight loss
Progressive swallowing difficulty, unintentional weight loss or vomiting blood need urgent OGD — not a fundoplication booking.
Procedure options
A wrap, a magnetic ring, or a bypass — the right one for you.
What each operation on the table actually involves — and which patient each one fits.
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Nissen 360° fundoplication
The gold standard for typical acid reflux with normal oesophageal motility. Best acid control — some cost in early dysphagia and gas-bloat.
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Toupet 270° posterior wrap
A partial wrap preferred for ineffective oesophageal motility. Less dysphagia and less gas-bloat, at the cost of slightly less acid control.
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Dor 180–200° anterior wrap
An anterior partial wrap used occasionally — mainly with very poor motility or after myotomy for achalasia.
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LINX magnetic sphincter
A ring of magnetic beads on a titanium wire placed around the gastro-oesophageal junction. Short recovery, preserved belching — not for BMI >35, large hernia or Barrett’s.
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Hiatus hernia repair
Cruroplasty for the hernia defect ± mesh reinforcement, combined with a fundoplication. Biological mesh preferred for the oesophageal hiatus.
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Redo fundoplication
For a slipped, disrupted or overly tight previous wrap — specialist upper GI unit only, higher morbidity, careful planning.
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Roux-en-Y gastric bypass for GORD
For patients with BMI over 35 and reflux — superior reflux control and durable weight loss in one operation.
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Consultant consultation only
An honest discussion of whether surgery is the right step — no obligation, and a plain-English explanation of your test results.
Our vetted UK network
A small panel of upper GI units, we picked them.
Specialist upper GI centres across London and the main UK cities. Not listed publicly — introductions are made privately, once we understand your work-up.
Selection criteria
How we choose every upper GI unit in our network.
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Consultant upper GI surgeons, not general lists — anti-reflux is a subspecialty
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High-resolution manometry and 24-hour pH-impedance available in-house
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LINX-trained centre for magnetic sphincter augmentation
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Specialist redo and para-oesophageal hernia experience where relevant
Safety and recovery
What to expect afterwards — honestly.
Modern anti-reflux surgery is safe in the right hands. The trade-offs worth planning around are early dysphagia, gas-bloat, and the small but real risk of a redo years down the line.
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Early dysphagia is common — and usually settles
Most patients find swallowing tight for two to six weeks after a wrap. Persistent dysphagia beyond three months affects five to ten per cent.
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Gas-bloat syndrome
A feeling of trapped wind, more common after a Nissen than a partial wrap. Small, frequent meals and avoiding fizzy drinks help.
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Difficulty belching or vomiting
After a full 360° Nissen, some patients cannot belch or vomit normally. LINX and partial wraps preserve this better.
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Wrap slippage or failure
The wrap can loosen or migrate over the years. Ten to thirty per cent recurrence at ten years; roughly five to ten per cent need a redo.
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Pneumothorax and splenic injury
Rare intra-operative complications during hiatus mobilisation. The team plans for and manages them if they occur.
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Vagal nerve injury and delayed emptying
The vagus nerves run at the hiatus. Injury is uncommon but can cause slow gastric emptying — screened for pre-op if suspected.
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Oesophageal perforation
A rare but serious complication. A specialist unit and a low threshold for on-table repair are the reasons we insist on upper GI expertise.
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LINX and MRI compatibility
Older LINX devices restrict MRI strength; newer devices are compatible up to 1.5T. The card you are given records the model and settings.
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Red flags after surgery
Severe chest pain, fever, breathlessness, vomiting blood or complete inability to swallow saliva are all reasons to call the unit or attend A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever operation was done — Nissen, Toupet, LINX or hernia repair — the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through your manometry, pH study or operation note before your review, just ask.
- 01 Header
Indication and operation chosen
Why the procedure was done — PPI-refractory reflux, hernia, LINX candidacy — and which operation was agreed with you.
- 02 Technique
Approach and anatomy
Laparoscopic or robotic; hiatus size; whether mesh was used; type of wrap (Nissen, Toupet, Dor) or LINX size, and short gastric division.
- 03 Findings
Manometry, pH and intra-operative notes
Your DeMeester score, LES pressure, motility pattern, hernia measurements and any incidental findings such as Barrett’s.
- 04 Impression
Diet plan, PPI wean and follow-up
Read this first: the diet ladder, when to stop the PPI, when to return to work and exercise, and when to come back for review.
Recognised by major UK insurers
Cover for anti-reflux surgery is usually funded when reflux is medically documented on manometry and pH-impedance. LINX cover varies by insurer. We confirm cover before booking.
Frequently asked
Everything we get asked about anti-reflux surgery.
Quick answers on Nissen vs Toupet vs LINX, cost, recovery, and whether you can come off the PPI afterwards.
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Who is a candidate for anti-reflux surgery?
Adults with typical reflux that does not respond to or is not tolerated with a proton pump inhibitor, and who have pathological acid exposure on a 24-hour pH-impedance study performed off PPI. Volume regurgitation, extra-oesophageal symptoms with objective evidence, large hiatus hernias and Barrett’s oesophagus are all considered too. Manometry must confirm the oesophagus contracts adequately — achalasia is a contraindication to a fundoplication.
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Nissen or Toupet — which fundoplication is better?
Nissen (360°) gives the strongest acid control and is the default for patients with normal oesophageal motility. Toupet (270° posterior) is preferred if manometry shows ineffective motility, because it causes less dysphagia and less gas-bloat while still controlling reflux well. Your consultant decides based on the manometry, not preference alone.
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What is LINX and how does it compare to a fundoplication?
LINX is a ring of small magnetic beads on a titanium wire placed around the lower oesophageal sphincter. It gives symptom control comparable to a fundoplication at one to three years with less gas-bloat and preserved belching. Downsides are more early dysphagia, less five-year durability data, and unsuitability for patients with BMI over 35, a large hiatus hernia or Barrett’s. Device cost adds roughly £3,000–£5,000.
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How much does private anti-reflux surgery cost in the UK?
Roughly £8,000–£12,000 for a laparoscopic Nissen or Toupet fundoplication and £12,000–£18,000 for a LINX procedure. A large hiatus hernia repair sits between £10,000 and £16,000, a redo fundoplication £14,000–£20,000, and a Roux-en-Y gastric bypass for reflux with obesity £13,000–£18,000. Pre-op work-up (OGD, manometry, pH-impedance) adds £1,800–£2,800.
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How long is recovery after a fundoplication?
Most people are home the day after surgery. You start with liquids for a few days, move to soft foods for one to two weeks and progress to normal texture over three to four weeks. Office work is realistic at one to two weeks, driving at one to two weeks, and heavy lifting or gym work at six weeks.
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Will I be able to stop my PPI?
Yes, in the majority of cases. Around 70 to 85 per cent of patients are off PPIs at one year after a well-selected fundoplication. Most stop within two to four weeks post-op on a manometry-guided protocol — but the wean is done under supervision, not overnight.
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How durable is the operation?
Ten-year satisfaction sits around 85 to 90 per cent. Symptomatic recurrence occurs in 10 to 30 per cent by ten years, and about five to ten per cent need a revision procedure. LINX has less long-term data than fundoplication but shorter-term results are broadly comparable.
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What if I have reflux and my BMI is over 35?
A Roux-en-Y gastric bypass is generally the better anti-reflux operation in this group. Meta-analyses show superior reflux control compared with fundoplication in obese patients, and you get durable weight loss in the same operation. LINX and standard fundoplication are avoided when BMI is above 35.
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When should I see a doctor urgently rather than book surgery?
Progressive difficulty swallowing, unintentional weight loss, vomiting blood, black stools, or new symptoms over the age of 55 need an urgent OGD to rule out a stricture or cancer — not a fundoplication booking. Chest pain that is new or severe needs same-day medical review.
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