Reflux & hiatus hernia

Reflux surgery

Medication controls the symptoms. Surgery repairs the valve.

Your surgeon: Stefanos Lazaridis MD, FRCS, Director, 11th Surgical Clinic for Obesity & Reflux, Metropolitan General, Athens · formerly NHS Consultant in Upper GI & Bariatric Surgery, London

Short answer

Anti-reflux surgery restores the valve between the oesophagus and the stomach, so acid and stomach contents stop coming back up. It treats the cause of reflux, not just the symptoms, and protects against complications such as oesophagitis and Barrett’s oesophagus. The standard operation is laparoscopic Nissen fundoplication, with repair of any hiatus hernia. If you also live with obesity, a gastric bypass is usually the better anti-reflux operation.

Who it is for

When should reflux be operated on?

The decision depends on tests, not just on symptoms. A good result starts with the right diagnosis.

Surgery is worth considering if you have

heartburn or regurgitation despite medication
good symptom control, but you do not want lifelong tablets
a hiatus hernia, especially a large one
regurgitation, hoarseness, chronic cough or night-time symptoms that tablets do not fix
oesophagitis or Barrett’s oesophagus

Surgery is usually not the answer if

tests do not confirm reflux
symptoms come from another cause, such as a motility disorder
you have significant obesity: a bypass is then preferred
symptoms are mild and well controlled, and you are happy with medication

Diagnosis first

The tests before surgery

Gastroscopy

Shows oesophagitis, Barrett’s oesophagus and the size of any hiatus hernia.

Oesophageal manometry

Measures how well the oesophagus pumps. It guides the choice of operation.

24-hour pH-impedance

Proves that reflux is really there, and links it to your symptoms.

The operation

Laparoscopic Nissen fundoplication

The oldest and best-tested anti-reflux operation
The top of the stomach is wrapped around the lower oesophagus to rebuild the valve
Any hiatus hernia is repaired at the same time
Done laparoscopically for more than 20 years, with little pain and quick recovery

Travelling for surgery

Coming from abroad

Length of stay, flying home, follow-up and emergencies: information for international patients.

Video consultation first

You send your history, endoscopy reports and any tests. We review them together by video call before you plan a trip.

Your own doctor kept informed

With your consent I send a full report to your GP or specialist at home. The specialist follow-up stays with us.

Follow-up after you fly home

Follow-up by video call and email, with a clear plan your local doctor can support.

Questions

Frequently asked questions

Will I be able to stop my tablets?

That is the aim, and most patients stop their reflux medication after successful surgery.

Will I be able to burp or vomit?

Some patients find burping harder in the first months. This usually settles with time.

I have reflux and I am overweight. Which operation?

With significant obesity, a fundoplication is less reliable and a gastric bypass treats both problems. A gastric sleeve can make reflux worse and is usually avoided.

I developed reflux after a gastric sleeve. What can be done?

Conversion of the sleeve to a bypass is the most effective treatment. See revisional surgery.

Next step

Find out if surgery can help your reflux

Send us your details and any test results, and I will contact you by phone or video call.

Book a consultation