Concierge upper-GI surgery · UK
Private hiatus hernia repair, by a consultant upper-GI surgeon.
A proper hiatus hernia repair — laparoscopic or robotic, with a full pre-op workup, biological mesh where indicated, and a partial fundoplication chosen to fit your anatomy.
Why patients choose us
- 01
A consultant upper-GI surgeon, in a proper theatre
Not a general list. A named surgeon who does hiatus hernia work weekly, in a hospital equipped for laparoscopic and robotic repair.
- 02
The right workup before you consent
OGD, CT, high-resolution manometry — and pH-impedance where reflux is the driver. We rule out achalasia before anyone touches the hiatus.
- 03
Independent, and free
We are paid by no hospital, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private hiatus hernia repair costs in the UK.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across two or three options.
In short
A laparoscopic hiatus hernia repair in our network: £8,000–£14,000, home in 1–2 nights.
| Procedure | Indicative range | Typical duration | Hospital stay |
|---|---|---|---|
| Laparoscopic hiatus hernia repair (type I/small) | £8,000–£11,000 | 2 h theatre | 1 night |
| Laparoscopic giant/para-oesophageal repair (types III/IV) | £10,000–£14,000 | 2.5–3 h theatre | 1–2 nights |
| Robotic-assisted hiatus hernia repair | £12,000–£16,000 | 3 h theatre | 1–2 nights |
| Revision hiatus hernia surgery | £14,000–£20,000 | 3–4 h theatre | 2–3 nights |
| Pre-op workup (OGD + CT + manometry ± pH) | £1,800–£2,800 | Two visits | 1–2 weeks |
| Consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by which surgeon does the case, by whether robotic instrumentation is used, and by whether biological mesh is required. We come back with a firm quote within one working day.
The problem
The right surgeon, the right workup, the right wrap.
Hiatus hernia repair is a technically demanding operation done badly by occasional operators. We match you to a high-volume upper-GI surgeon who does this weekly — and insist on the workup that keeps the operation safe.
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Is surgery actually needed?
Small type I hernias often only need medication and lifestyle changes. We say so before you consent.
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Is the anatomy fully mapped?
OGD, CT, high-resolution manometry — and pH-impedance where reflux is the driver. Achalasia must be ruled out.
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Toupet or Nissen — and why?
A partial wrap is usually the more balanced choice after a hiatal repair. Your surgeon should explain the trade-off.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the recovery window and diet progression.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Admission, theatre and ward
Phase 3 · After
Diet progression and review
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, imaging or scopes so far, and whether reflux, dysphagia or chest pain is the driver.
- 02
Before
We come back with a recommendation
Within one working day: the right surgeon, the right investigations still needed, and an indicative price. If watchful waiting is the honest answer, we say so.
- 03
Before
Workup and pre-assessment
OGD, CT chest/abdomen, high-resolution manometry and — where indicated — pH-impedance. Bloods, anaesthetic review, and a clear pre-op plan.
- 04
On the day
Admission and anaesthetic
Same-day admission, consent with your surgeon and anaesthetist, and general anaesthetic in a licensed theatre.
- 05
On the day
The repair itself
Two to three hours. Laparoscopic or robotic: sac excision, cruroplasty, mesh reinforcement where indicated, and usually a partial fundoplication (Toupet) with gastropexy.
- 06
On the day
One to two nights in hospital
ERAS pathway — early mobilisation, sips of water the same evening, and home when comfortable and eating soft food.
- 07
After
Diet progression and review
Liquids for a week, soft diet for three, normal by four to six weeks. Surgical review at six weeks, and imaging if symptoms suggest a problem.
Typical end-to-end: 3–4 weeks from enquiry to surgery. Full recovery: 4–6 weeks.
When it helps
When hiatus hernia repair is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Large para-oesophageal hernia
Type II, III or IV — more than half the stomach in the chest, often symptomatic and worth repairing even when reflux is mild.
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Dysphagia or food sticking
Solid food that lodges at the lower oesophagus, often with regurgitation — a mechanical problem the hernia is causing.
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Postprandial chest pain or fullness
Pain, breathlessness or bloating after meals as the stomach fills in the chest cavity.
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Iron-deficiency anaemia from Cameron’s ulcers
Linear ulcers in the herniated stomach that bleed slowly — a common, easily missed reason for unexplained anaemia.
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Aspiration or recurrent chest infections
Reflux of gastric contents into the airway, causing nocturnal cough, hoarseness or pneumonia.
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Reflux persisting despite maximal PPI
When medication and lifestyle are not enough and imaging shows a significant hiatal defect driving the reflux.
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Redo surgery for recurrent hernia
A previous repair that has slipped or recurred — technically demanding, and best done by a surgeon who does this weekly.
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Red flag: gastric volvulus
Sudden severe chest or upper-abdominal pain with retching and inability to vomit is a surgical emergency — A&E, not a clinic booking.
Procedure options
One repair, several honest choices.
Types I to IV, laparoscopic or robotic, mesh or no mesh, Toupet or Nissen — the surgeon explains the trade-off and you decide together.
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Laparoscopic repair with cruroplasty
Keyhole surgery: sac excision, closure of the widened hiatus with sutures, and a fundoplication to prevent reflux.
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Mesh-reinforced cruroplasty (biological)
For hiatal defects greater than 5 cm — a biological mesh (Strattice, Permacol) reinforces the closure. Synthetic mesh is used with great caution.
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Toupet (270°) partial fundoplication
The preferred wrap after hiatal repair for most patients — controls reflux while reducing the risk of post-op dysphagia and gas-bloat.
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Nissen (360°) fundoplication
A full wrap, used selectively for severe reflux with normal motility. Slightly more effective for reflux, slightly more side-effects.
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Robotic-assisted repair
Robotic instrumentation gives better visualisation and articulation deep in the mediastinum — useful in giant and redo hernias.
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Gastropexy (stomach fixation)
Fixation of the stomach to the abdominal wall, often used in frail patients where a full wrap is too high a risk.
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Revision surgery
For recurrent hernia or a slipped wrap. Technically demanding, and best done in a high-volume unit.
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Consultation and workup only
A full assessment with OGD, CT and manometry — and an honest answer about whether surgery is the right step at all.
Our vetted UK network
A small panel of upper-GI surgeons, we picked them.
Consultant upper-GI surgeons across London and the major UK cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant upper-GI surgeons, high-volume — not occasional operators
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Access to laparoscopic and robotic platforms
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On-site high-resolution manometry and pH-impedance testing
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ERAS pathway with dietitian-led post-op diet progression
Safety and recovery
What to expect afterwards — honestly.
Hiatus hernia repair is a safe operation in high-volume hands, but it is a real operation. Outcomes are 85–95% symptom improvement, with a real long-term recurrence rate for giant hernias worth knowing about.
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A general anaesthetic in a proper theatre
A two-to-three hour operation under GA with a full anaesthetic team. Not a day-case for most patients.
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Early dysphagia is common and settles
Swallowing is often awkward for the first two to four weeks as the wrap and hiatus swell. It almost always eases.
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Gas-bloat and inability to belch
A known trade-off of any fundoplication — worse with Nissen, milder with Toupet. Improves over months.
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Liquid → soft → normal over 4–6 weeks
A strict staged diet protects the repair. Rushing it is the commonest cause of stitch problems and early recurrence.
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Mesh erosion is rare but serious
Biological mesh is preferred at the hiatus because synthetic mesh has been reported to erode into the oesophagus. Your surgeon will explain the trade-off.
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Pneumothorax and pleural injury
The dissection is next to the pleura — small pneumothoraces occasionally happen and are usually managed without a chest drain.
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DVT and PE prophylaxis
Heparin injections, TED stockings and early mobilisation are standard. Continue as directed after discharge.
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Recurrence: 10–30% for giant hernias
Small type I repairs are durable. Type III/IV giant hernias have a real long-term recurrence rate — worth knowing before surgery.
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Red flags after surgery
Severe chest pain, breathlessness, high fever, uncontrolled vomiting or inability to swallow saliva — call the on-call team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, 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 the note before your review, just ask.
- 01 Header
Hernia type, size and technique
What type of hiatus hernia was found (I–IV), the size of the hiatal defect, and whether the repair was laparoscopic or robotic.
- 02 Technique
Cruroplasty, mesh and wrap
How the crura were closed, whether biological mesh was used, and which wrap (Toupet, Nissen) or gastropexy was performed.
- 03 Findings
Intra-operative findings
Notes on the sac, any Cameron’s ulcers, the length of intra-abdominal oesophagus, and any incidental findings.
- 04 Impression
Diet plan, recovery and review
Read this first: staged diet, when to resume PPI, when to lift heavy things again, and when the surgical review is booked.
Recognised by major UK insurers
Cover for hiatus hernia repair is usually funded when medically indicated. Cover for robotic instrumentation and biological mesh varies by insurer — we confirm before booking.
Frequently asked
Everything we get asked about hiatus hernia repair.
Quick answers on cost, wrap choice, mesh, recovery and when to worry.
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What is a hiatus hernia and why does it need repair?
A hiatus hernia is a defect in the diaphragm that lets part of the stomach — and sometimes other organs — slide into the chest. Small type I hernias often only need medication. Large para-oesophageal hernias (types II–IV) can cause dysphagia, chest pain, anaemia from Cameron’s ulcers, or a life-threatening gastric volvulus, and are the ones that usually need surgery.
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Is hiatus hernia repair the same as anti-reflux surgery?
No — but they overlap. Anti-reflux surgery focuses on stopping reflux. Hiatus hernia repair focuses on putting the stomach back where it belongs and closing the hiatal defect. In practice, most hiatal repairs include a partial fundoplication (usually Toupet) to prevent reflux afterwards.
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How much does a private hiatus hernia repair cost in the UK?
Roughly £8,000–£11,000 for a straightforward laparoscopic repair, £10,000–£14,000 for giant type III/IV hernias, and £12,000–£16,000 for robotic-assisted repair. Revision surgery is £14,000–£20,000. Pre-op workup adds £1,800–£2,800. We come back with a firm quote within one working day.
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How long is the operation and how long will I stay in hospital?
Two to three hours in theatre under general anaesthetic. Most patients stay one to two nights on an enhanced recovery (ERAS) pathway — home when comfortable, mobile and eating soft food.
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Why do you recommend a Toupet wrap over a Nissen?
After a hiatal repair the swallowing tube is often more vulnerable to a tight wrap. A Toupet (270°) partial wrap controls reflux almost as well as a Nissen (360°) but with less post-op dysphagia and less gas-bloat — for most patients it is the more balanced choice.
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What is mesh used for, and is it safe at the hiatus?
Mesh reinforces the sutured hiatus when the defect is greater than about 5 cm, to reduce recurrence. At the hiatus we prefer biological mesh (Strattice, Permacol) because synthetic mesh has been reported to erode into the oesophagus — a rare but catastrophic problem. Your surgeon will explain the trade-off in your case.
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What does recovery look like — diet and time off work?
Liquids for the first week, soft diet for three weeks, normal food by four to six weeks. Most office workers take two to three weeks off; heavy manual jobs and gym-based training wait six weeks. Early dysphagia is common and almost always settles.
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What are the chances the hernia comes back?
Small type I repairs are durable. For giant type III/IV hernias, honest long-term recurrence rates are 10–30% at five to ten years — often symptom-free and not needing further surgery. High-volume surgeons and appropriate mesh use reduce that risk.
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When should I go to A&E rather than book a clinic appointment?
Sudden severe chest or upper-abdominal pain, retching without being able to vomit, or a distended upper abdomen can signal gastric volvulus — a surgical emergency. Also go the same day for heavy GI bleeding, severe breathlessness or high fever after surgery.
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