Specialist Upper Gastrointestinal & Bariatric Surgeon
Secretary: Elizabeth Venn
Telephone: 07903 069 861
Specialist Upper Gastrointestinal & Bariatric Surgeon
As a specialist in anti-reflux & hiatus hernia surgery, Mr Clarke follows current national and international guidelines (see resources) using keyhole (laparoscopic) techniques, with many patients able to be discharged the same day.
This is a condition in which acid leaks from the stomach into your gullet (oesophagus).
The valve (sphincter) between the stomach and gullet (oeosphagus) which normally relaxes to allow food to pass into the stomach and stops acid leaking back into the gullet, can become weak or relax inappropriately. This results in leakage of acid from the stomach into the gullet (oeosphagus).
Risk factors for this include:-
The diagnosis is normally made on the basis of your symptoms. However where your doctor is uncertain, your symptoms are persistent or unusual (e.g. swallowing difficulty or weight loss), where medications do not work or where surgery is being considered, you may be referred for further tests. These could include:-
This may be considered in the following circumstances:-
All patients being considered for surgery are advised to undergo upper GI endoscopy, as well as oesophageal high resolution manometry and 24-hr pH studies in order to confirm the diagnosis and assess the anatomy of the stomach and gullet (oeosphagus).
The aim of surgery is restore the normal anatomy at the diaphragm (by ensuring that the stomach is lying within the abdomen and any hiatus hernia is corrected) and to reinforce the valve (sphincter) at the junction between the gullet and stomach.
Once a decision is made to go ahead with surgery, you will need to attend the pre-assessment clinic, at which a number of routine checks and blood tests will be performed.
Surgery is performed with keyhole (laparoscopic) surgery. Five tiny incisions are made in the upper part of the tummy (abdomen). The operation involves closing any weakness in the diaphragm with stitches and then wrapping the top section of the stomach (fundus) around the lower end of the gullet (oesophagus) to reinforce the pressure valve (sphincter). This is known as a ‘fundoplication’ or ‘wrap’. The procedure normally takes less than 1 hour and takes effect immediately.
All anti reflux medication can be stopped immediately following surgery. Some patients are discharged on the same day as the operation (daycase). Patients are normally ready to be discharged around 4-6 hours following surgery. You will be discharged with painkillers and written post-operative instructions. All stitches are dissolvable. The waterproof dressings are suitable for the shower and can be removed after 7 days.
You are advised to drink fluids only for the initial 24 hours after surgery before commencing a mashed diet for the following 2-3 weeks. More solid foods can then be gradually reintroduced as tolerated.
Recovery can take around two weeks however you are advised to avoid heavy lifting for up to 6 weeks after surgery.
Recurrence – 10-15% of patients may develop recurrent symptoms such as heartburn or acid regurgitation in the future
This is a condition in which part of the stomach slips through the opening in the diaphragm (hiatus) into the chest. There are two main types:-
It is thought to arise as a result of weakening of the muscle of the diaphragm and/or increased pressure in the abdomen.
Risk factors include:-
This is dependent on the size and type of hiatus hernia. Symptoms include:-
No specific treatment is required in those with no symptoms. Where acid reflux is present this should initially be managed by lifestyle measures such as maintaining a healthy weight, eating small regular meals and stopping smoking. Where these measure are ineffective, medical treatment using antacid medication and/or proton pump inhibitor drugs is used. Surgery may be considered in the following circumstances:-
Surgery is considered in those patients with symptoms or where there is a risk of complications relating to the hiatus hernia.
Once a decision is made to go ahead with surgery, you will need to attend the pre-assessment clinic, at which a number of routine checks and blood tests will be performed.
Surgery is performed with keyhole (laparoscopic) surgery. Five tiny incisions are made in the upper part of the tummy (abdomen). The operation involves restoring the normal anatomy at the opening in the diaphragm (hiatus) by reducing the stomach back into the abdomen, closing any weakness in the diaphragm with stitches. In some cases the top section of the stomach (fundus) is wrapped around the lower end of the gullet (oesophagus) to minimise reflux and fix the stomach within the abdomen. This is known as a ‘fundoplication’ or ‘wrap’. The procedure normally takes upto 2 hours.
All anti-reflux medication can be stopped immediately following surgery. Most patients are discharged the following day after surgery. You will be discharged with painkillers and written post-operative instructions. All stitches are dissolvable. The waterproof dressings are suitable for the shower and can be removed after 7 days.
You are advised to drink fluids only for the initial 24 hours after surgery before commencing a mashed diet for the following 2-3 weeks. More solid foods can then be gradually reintroduced as tolerated although in some cases you may be advised to maintain the mashed diet for a longer period.
Recovery can take around two weeks however you are advised to avoid heavy lifting for up to 6 weeks after surgery.
I highly commend his approachable friendly manner. He made me feel at ease and informed through all aspects of my treatment and surgery.
Surgery, care and follow-up were carried out to a very high standard. I wouldn't hesitate to recommend Mr Clarke to others.
I found Mr Clarke extremely confident in this line of surgery, knowledgeable and very nice. Had a great ability to keep me at ease throughout.
Perfect from referral to discharge. Everything explained fully. Every discussion with Mr Clarke was perfectly judged.
Mr Clarke was outstanding from the start of my treatment to the end. He was empathetic, knowledgeable, respectful and made you feel at ease.
Mr Clarke was extremely efficient both in consultation and surgery. He was very caring and took time to explain procedures.I would highly recommend him.
Very pleased with outcome of op from Mr Clarke. Just like 2016 he was very helpful and so professional. Would definitely recommend.
Excellent manner both in consultation, pre- and post-op. Would definitely be happy to see him and recommend to others requiring surgery.
Mr Clarke made the whole experience a breeze. So calm, polite and understanding of patients' needs.
My introduction to Mr Clarke was met with a warm smile and a firm handshake. He was professional and friendly and put me at ease. I have no hesitation in recommending Mr Clarke.
Mr Clarke did everything he said he would. Appointments came through quickly and I was made to feel comfortable and I had confidence in Mr Clarke from the outset.
Mr Clarke has been most helpful to my specific situation. He made allowances for me and adapted to my particular health issues.
Mr Clarke could not have done more for me. He looked after me and made me feel important and safe.
Whole experience was very professional, so felt safe in his hands. Communication so important and Mr Clarke was brilliant.