Garrick Hospital

Patient testimonial: Lifesaving emergency robotic surgery at Garrick Hospital

Viktoriia Davydenko — Mon, 22 Sep 2025 11:02:13 +0000

“I have visited many top-class hospitals globally and can say that Garrick Hospital is up there. Terrific customer service with competent healthcare professionals and a world-class facility.”

Whilst on holiday in Stranraer, Mr A developed abdominal pain and sought medical advice at Garrick Hospital.

In September 2024, Mr A had undergone surgery for stomach cancer in Turkey. Since then, he had been complaining of abdominal discomfort and excessive belching after eating and had not been able to progress his diet fully because of this. He saw Dr Andrew Gaya, Consultant Oncologist at Garrick Hospital, who found no evidence of recurrence of the cancer on CT scan, but there was a significant incisional hernia containing large bowel. He therefore referred Mr A on to Professor Shaun Preston, Consultant Surgeon at Garrick Hospital. “I repaired the incisional hernia but was concerned that his symptoms had not completely resolved.”

When Mr A then developed further abdominal pain and vomiting, Prof Preston shares “I arranged an emergency CT scan which demonstrated an internal hernia and occlusion of the major vein draining the intestines that had not evident on the prior scan.”

Mr A explains “The scan revealed the time bomb; the twisted intestine and distressed vein that potentially saved my life!”

Professor Preston performed lifesaving emergency surgery using Garrick Hospital’s da Vinci Xi robot, which is a robotic-assisted surgical system that improves patient recovery and enhances surgical strategy, to fix the internal hernia.

He found that the small intestines had been reconstructed with a 360-degree twist at the time of the gastric cancer surgery, which explained the ongoing symptoms and failure to progress. Using advanced robotic surgery, Prof Preston was able to take down the prior surgery and reconstruct the intestines, correcting the prior twist, and closed the space where the internal hernia had occurred. This major surgery was completed without the need for a cut in the abdomen larger than 12mm.

Prof Preston stated, “We immediately scheduled an operation to fix this, and I am pleased to say the Mr A has recovered well and was able to return home.”

Internal hernias can occur after any surgery where the bowel has been divided and a gap left in the mesentery (the fatty tissue that carries blood to the bowel), such as weight loss surgery (gastric bypass) or after stomach cancer surgery.

“Internal hernias can be very difficult to identify, even on CT scan. To avoid disaster, a high index of suspicion and timely intervention are essential”. Prof Preston shared.

Prof Shaun Preston is a distinguished general surgeon and has an international reputation in the fields of oesophageal, gastric and robotic surgery. He uses the advanced robotic skills to perform complex surgery on the stomach, oesophagus, hiatus hernias and abdominal wall hernias.

“I will be most delighted to recommend Prof Preston anytime to anyone who desires an experienced, thorough, and compassionate gastric surgeon. Prof Preston is one of the best in his field. And, I also dare say, that he has one of the best secretaries in Andreea Onet.” Mr A commented, “Whilst handling my case, he demonstrated a very high level of professionalism, confidence, and an unmatched mastery of his field.”

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Understanding aortic stenosis: How TAVI can help

P White — Mon, 22 Sep 2025 09:09:25 +0000

Aortic stenosis is a common yet serious heart condition that affects thousands of people every year, particularly older adults. Fortunately, advances in treatment have made it easier than ever to manage this condition.

One of the most exciting developments is transcatheter aortic valve implantation (TAVI), a minimally invasive procedure providing new hope to patients who aren’t able to undergo open heart surgery. In this blog, we’ll take a closer look at aortic stenosis, including symptoms, how it’s diagnosed, and why TAVI might be the most effective treatment option for you.

What is aortic stenosis?

Aortic stenosis is a heart condition where the aortic valve (the ‘gateway’ between the heart's left ventricle and the aorta) becomes stiff and narrowed, restricting blood flow from the heart to the rest of the body.

When the aortic valve becomes narrowed, the heart must work harder to pump blood. This can lead to symptoms such as chest pain, shortness of breath, fatigue, dizziness, and in severe cases, syncope and heart failure.

Aortic stenosis is most often caused by age-related calcium build-up on the valve. It can also occur as a result of congenital defects (those present from birth) or complications from infections.

While some people may not experience symptoms for years, untreated severe aortic stenosis can be life-threatening.

Aortic stenosis symptoms

Symptoms often develop gradually and may include:

chest pain or tightness, especially during physical activity
shortness of breath, which worsens with exertion
fatigue
dizziness or fainting
heart palpitations
swelling in the ankles or feet, which can be a sign of heart failure
a decline in your ability to do normal activities

Many people with aortic stenosis may not notice symptoms until the condition is at an advanced stage. However, if you begin to feel unusually fatigued or notice a decline in your ability to stay active – especially if you’re older – you should visit a specialist as soon as possible.

Aortic stenosis diagnosis

Aortic stenosis is typically diagnosed through a combination of a physical exam and various imaging tests that help assess how well your aortic valve is working and how severe the narrowing is.

Your consultant will begin the process by listening to your heart with a stethoscope. If they hear a heart murmur (a whooshing sound caused by a turbulent blood flow through the heart), they may suspect aortic stenosis. From there, they’ll recommend tests to confirm the diagnosis and understand how serious it is.

Common tests used to diagnose aortic stenosis include:

Echocardiogram – The most important test, which shows how blood flows through the heart and how well the aortic valve opens and closes. It also helps measure how narrow the valve is.
Electrocardiogram (ECG) – This records the heart’s electrical activity and can show signs of strain or rhythm problems, though it doesn’t diagnose stenosis directly.
Chest X-ray or CT scan – These can reveal changes in lungs, heart size or calcium buildup on the valve.
Exercise testing – Sometimes used to see how your heart responds to physical activity, especially if symptoms are unclear.
Cardiac catheterisation – This is a more detailed test of coronary arteries that may be used if other results are inconclusive, or before planning treatment.

Aortic stenosis FAQs

How fast does aortic stenosis progress?

Aortic stenosis can progress at different speeds depending on your age, overall health, and the cause of the condition. For many people, it develops slowly over several years without causing symptoms. However, once symptoms like chest pain, breathlessness, or fainting begin, aortic stenosis can rapidly worsen, and urgent treatment may be required.

Regular monitoring is important to catch changes early. Patients with mild cases are usually checked every few years, while moderate and severe cases need more frequent follow-ups. Heart scans like echocardiograms help track how well your valve is working and guide decisions about treatment.

Some people may see faster progression, especially if they were born with a valve problem or have other health issues like high blood pressure, diabetes, or kidney disease. Lifestyle factors such as smoking and high cholesterol can also speed things up.

Is aortic stenosis hereditary?

Aortic stenosis is usually caused by aging, but in some cases, it can run in families.

One common inherited cause is a condition called bicuspid aortic valve, where the valve has two flaps or leaflets instead of the usual three. This can lead to narrowing of the valve over time and is often passed down from parents to children.

There are also certain genes that may increase the risk of developing aortic stenosis, but having these genes doesn’t guarantee you’ll get the condition. Lifestyle factors like smoking, high blood pressure, and cholesterol also play a big role.

If someone in your family has aortic stenosis – especially at a younger age – it’s a good idea to talk to your doctor. They may recommend a heart check-up to see if you’re at risk.

Does aortic stenosis cause coughing?

Aortic stenosis can cause coughing, although it's not one of the more common symptoms.

Coughing may happen when the narrowed aortic valve makes it harder for the heart to pump blood effectively. This can lead to fluid build-up in the lungs, a condition known as pulmonary edema. When this happens, the cough may be persistent and can feel different from a typical cold or allergy-related cough. It might be dry and hacking, or in more serious cases, produce frothy or pink-tinged mucus.

The cough may also get worse when lying down or during physical activity, as these situations put extra strain on the heart. Not everyone with aortic stenosis will experience coughing, but if you do, it’s important to speak with a specialist – particularly if it's new or persistent.

Aortic stenosis treatment

Transcatheter aortic valve implantation (TAVI)

Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat aortic stenosis. While this condition was traditionally managed with open-heart surgery, TAVI now offers a less invasive alternative which is particularly well-suited for older adults or those considered high-risk for conventional surgery.

Unlike traditional valve replacement, TAVI does not require opening the chest or stopping the heart. Instead, a catheter is inserted through a blood vessel, usually in the groin, and guided to the heart. Through this catheter, a new valve is carefully positioned inside the narrowed aortic valve and expanded to take over its function. The procedure is typically performed under local anaesthesia or light sedation, and most patients are able to go home within a couple of days.

TAVI is particularly beneficial for those who may not tolerate major surgery well, such as elderly patients or those with other medical conditions. It offers a faster recovery time, reduced hospital stays, and significant improvement in symptoms like breathlessness, chest pain, and fatigue. Many patients report feeling better within days and are able to return to normal activities much sooner than with traditional surgery.

Like any medical procedure, TAVI carries certain risks, including valve leakage (paravalvular regurgitation), stroke, vascular complications, kidney damage, or the need for a permanent pacemaker. However, these risks are generally low.

Nowadays, TAVI is considered as effective as open heart surgery for many patients with severe aortic stenosis. Recent studies and NHS guidance have led to its wider adoption, not only for those at high surgical risk but also for patients at intermediate and even low risk – making it a viable option for a broader range of individuals.

Benefits of TAVI

There are several key benefits to TAVI for patients with aortic stenosis:

Minimally invasive approach: TAVI is carried out using a catheter inserted through a blood vessel, typically in the groin, which means there's no need for open-heart surgery. This reduces physical trauma, avoids large incisions, and eliminates the need to stop the heart during the procedure.
Faster recovery time: Because TAVI is less invasive, patients often experience shorter hospital stays and a quicker return to everyday activities. This is especially beneficial for older adults or those with limited mobility.
Improved quality of life: With reduced symptoms and a faster recovery, patients often experience a noticeable improvement in their overall well-being, independence, and ability to participate in daily life.
Suitable for high-risk patients: TAVI is particularly suitable for patients who are considered high-risk for traditional surgery due to age, frailty, or other health conditions. It offers a safer alternative with fewer complications and less strain on the body.
Comparable effectiveness to surgery: Clinical studies have shown that TAVI provides outcomes similar to open heart surgery in terms of survival and symptom improvement. It is now approved for use in patients at intermediate and even low surgical risk.

TAVI FAQs

How long does a TAVI procedure take?

A TAVI procedure typically takes about one to two hours from start to finish. It’s much shorter than traditional open heart surgery and is usually performed in a catheter lab.

After the procedure, patients are monitored closely and usually stay in hospital for one to three days, depending on recovery and overall health. Many people can return to normal activities within a week or two.

How long does a TAVI valve last?

TAVI valves are designed to be durable, and current research shows they can last at least 10 to 15 years in many patients. Most people still have a well-functioning valve six to eight years after the procedure, and ongoing studies continue to monitor long-term performance.

The exact lifespan of a TAVI valve can vary depending on factors like:

age and overall health
activity level
type of valve used
presence of other medical conditions, such as kidney disease or diabetes

Because TAVI is a relatively newer procedure compared to surgical valve replacement, long-term data beyond 15 years is still being collected. However, current results are promising and suggest that TAVI valves offer good durability for most patients.

How much does a TAVI procedure cost?

For the latest self-pay pricing, please visit our dedicated TAVI webpage.

At Garrick Hospital, TAVI is offered as a fixed price package. This means that everything you may need for treatment is grouped into one clear price, including pre-admission tests, the procedure, professional fees, post-op outpatient care, and any other consultant-recommended services.

TAVI may also be covered by your private medical insurance. Please confirm with your insurer before booking an appointment at the hospital.

This service is led by Dr Tito Kabir and Dr Mohssen Chabok, Consultant Cardiologists.

Discover cardiac care at Garrick Hospital >

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UK childhood vaccination schedule: What’s changing?

P White — Tue, 09 Sep 2025 12:59:14 +0000

From 1 July 2025, the UK’s childhood immunisation schedule has undergone several important updates. These changes reflect the latest advice and are designed to better safeguard children against serious illnesses. One of the most notable additions is the introduction of the chickenpox (varicella) vaccine, which will be available free on the NHS from January 2026.

Here’s a simple breakdown of what’s changing and why it matters.

What’s new in the vaccination schedule?

Chickenpox vaccine added to NHS programme

Starting January 2026, eligible children will receive a combined MMRV vaccine (measles, mumps, rubella, and varicella) as part of their routine immunisations. 

This vaccine has been used safely for decades in countries like the US and Australia. It helps prevent chickenpox and its complications, such as bacterial infections, pneumonia, and even stroke.

Why it matters: Chickenpox can cause serious illness and lead to missing school and work for families.

Earlier protection against Meningococcal B (MenB)

The second dose of MenB will now be given at 12 weeks instead of 16. 

Why it matters: Young infants are most vulnerable to illnesses caused by the Meningococcal bacteria (MenB), so earlier vaccination offers better protection during this critical period.

Pneumococcal vaccine (PCV13) timing adjusted

The first dose of PCV13 is now given at 16 weeks instead of 12. 

Why it matters: This change helps spread out injections more evenly across appointments, making visits less stressful for babies and parents.

Hib/MenC vaccine removed at 12 months

Children born on or after 1 July 2024 will no longer receive the Hib/MenC (Menitorix®) vaccine at 12 months.

Why it matters: High coverage in adolescents means that infants are already well protected indirectly. There are alternative Meningitis C vaccines available for infants if required, but will not be offered on the NHS schedule.

New 18-month appointment introduced

From January 2026, children will be invited for a new 18-month vaccination appointment, which includes:

a booster dose of the hexavalent vaccine (protects against diphtheria, tetanus, pertussis, polio, Hib, and hepatitis B)
the second dose of the MMR vaccine

Why it matters: This change improves uptake and ensures children are protected before starting nursery or school.

Summary of key changes

12 weeks: MenB (2nd dose)
16 weeks: PCV13 (1st dose)
12 months: No Hib/MenC for children born after 1 July 2024
18 months: New appointment including Hexavalent booster + MMR (2nd dose)
January 2026: Chickenpox vaccine added via MMR

Where to find out more information

For the full NHS vaccination schedule, visit the NHS website. 

For government guidance on schedule changes, visit the UK government website.

Final thoughts from Dr Ioannou

“These updates reflect the UK’s commitment to keeping children safe through timely and effective immunisation. The addition of the chickenpox vaccine is a major step forward, and the revised schedule ensures better protection with fewer appointments. If you have questions, speak to your GP or health visitor - they’re here to help.”

Dr Yiannis Ioannou is a general paediatrician based in Stranraer.

As a general paediatrician and father of two young children, Yiannis is happy to consult on all conditions affecting children and young people and offers well baby checks and general health assessments.

Visit Dr Ioannou's profile >

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Patient testimonial: Sandy’s lifesaving cardiac operation

P White — Wed, 06 Aug 2025 15:16:31 +0000

Sandy first began experiencing concerning symptoms in 2019 when he had shortness of breath and fatigue. After undergoing tests, Sandy was told he had a leaking valve in his heart.

He had regular checkups but continued to experience symptoms, which got worse. He decided to seek advice and was recommended to visit Mr Inderpaul Birdi, Consultant Cardiac Surgeon from the Keyhole Heart Clinic and Garrick Hospital, by a friend.

On a Thursday morning, Sandy sent over details of his condition and his medical records. The Keyhole Heart Clinic team followed up with a call and then arranged an online call with Mr Birdi for the Monday evening.

After discussing his history and symptoms, Mr Birdi advised that Sandy needed to get some additional tests done, and this could be done in Scotland or Stranraer. Sandy and his wife decided to visit Stranraer the week after to undergo the necessary tests and have a follow-up appointment with Mr Birdi.

After undergoing some initial tests, it was discovered that Sandy had a blockage in his heart. He had planned to go home after the tests, but Mr Birdi invited him to have an angiogram done the next morning as he was concerned about the results.

After the angiogram, Sandy was advised he had a life-threatening blockage of his heart. He was offered a choice – go home and speak to his family about the next steps or have an operation in the next few days.

Sandy chose to go through with the minimally invasive operation on Saturday morning at Garrick Hospital. He spent two days in Intensive Care, was walking on Tuesday, and discharged on Wednesday, making his way home to Glasgow the same day.

Mr Birdi said: “Sandy came to see me with shortness of breath and despite extensive investigation his local doctors were unable to find the cause. After undergoing some initial tests, we discovered he had a serious heart artery blockage which needed immediate treatment. Fortunately, we were able to arrange an operation within a few days, and I performed an operation to remove the blockage. Because I was able to treat him with a minimally invasive technique, he was able to recover quickly and return home within five days. Since the operation, Sandy has made a good recovery.”

Sandy praised the team at Keyhole Heart Clinic and Garrick Hospital, thanking them for their continuing support before, during, and after his operation.

“The staff have been phenomenal. It gave me a little hope that there are good people out there. They care so much, and they’re so dedicated to their jobs. They were all so helpful, and they just kept assuring you that everything would be fine. I think everybody went above what they had to do. They were just so caring and so understanding.”

Garrick Hospital has a world-leading Heart and Lung Centre, which offers cardiothoracic surgery. We treat a broad spectrum of conditions affecting organs within the chest, including cancer, heart disease, valvular disease, pleural disease, and more.

With a distinguished team of cardiothoracic surgeons, we are one of few private hospitals in the UK to provide cardiothoracic surgery using minimally invasive (keyhole) techniques.

Mr Inderpaul Birdi, Consultant Cardiac Surgeon, is highly experienced in performing cardiac surgery, including heart valve repair and replacement, coronary artery surgery, and heart bypass surgery. He has a special interest in keyhole and minimally invasive surgery.

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Patient testimonial: From a Bupa GP appointment to lifesaving care

P White — Fri, 25 Jul 2025 14:43:03 +0000

In late 2023, Mr Whitehill began feeling unwell and visited a GP at a Bupa centre. While the initial assessment suggested nothing serious, the doctor took the time to conduct a more thorough examination. Upon closer inspection of Mr Whitehill’s throat, concerns were identified, and a same-day referral was made to Garrick Hospital for Mr Whitehill to see Mr Asit Arora, a consultant renowned for treating patients with a calm and compassionate approach, for suspected head and neck cancer.

“If I never went to the Bupa GP, this thing would’ve been burbling away in me and I wouldn’t have known,” Mr Whitehill shared. “I saw the GP at 11am and by 3pm the same day, I had a referral email to Mr Arora.”

In early 2024, Mr Whitehill met with Mr Asit Arora, an expert recognised internationally for pioneering transoral robotic surgery (TORS) in the UK. For someone who had rarely needed hospital care before, Mr Arora’s reassuring presence made a world of difference.

Under Mr Arora’s expert care, Mr Whitehill underwent TORS, a minimally invasive surgical technique that uses a robotic system to find and remove head and neck cancer. Thanks to this advanced technology and the skill of the surgical team, Mr Whitehill has since made a steady and successful recovery.

“After undergoing diagnostic tests at Garrick Hospital, I was able to diagnose Mr Whitehill with throat cancer and reassure him that he was in the best place for managing the problem,” Mr Arora shared.

After discussing his treatment options, Micheal elected to undergo TORS to completely remove the cancer. In addition, he underwent a neck operation to remove potentially involved lymph nodes.

“We were all delighted when the results confirmed that the throat tumour had been completely excised and there were no pathologically involved lymph nodes.”

This meant that Michael avoided the need for gruelling additional treatment, such as radiotherapy or chemotherapy.

Mr Arora said: “This targeted approach represents a really excellent treatment option because it’s a minimally invasive technique which gets a curative outcome without compromising on long term swallow function. Mr Whitehill undergoes regular monitoring, and his recovery thus far has been absolutely spot on.

We’re proud to offer some of the most advanced head and neck cancer treatments available. Our multidisciplinary team works closely to ensure every patient receives the highest standard of care from diagnosis through to recovery.”

Today, Mr Whitehill is back to enjoying life, deeply grateful for the professionalism, compassion, and expertise that guided him through his journey.

“Everybody from the nursing staff to the catering staff were so wonderful and the food was fantastic. I will always be grateful to Mr Arora for his expertise in the operating theatre and how we eased me through a difficult time.”

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Single-sided deafness: How a cochlear implant can help

P White — Tue, 08 Jul 2025 08:30:10 +0000

Living with hearing in only one ear – known as single-sided deafness (SSD) or unilateral deafness – can greatly impact your daily life and emotional well-being. It can affect your ability to follow conversations, locate sounds, and feel connected in social settings.

Thanks to advances in hearing technology, cochlear implants are now a proven treatment option for many people with single-sided deafness. These small, surgically implanted devices can help restore hearing in the deaf ear, improving sound awareness and speech understanding.

In this blog, we’ll explore what single-sided deafness is, the challenges it can present, and how cochlear implants help restore the sensation of sound.

Discover our cochlear implant service >

What is single-sided deafness?

Single-sided deafness (SSD) is a type of hearing loss where a person has little to no hearing in one ear, while the other ear functions normally or near normally. This condition can make everyday listening more difficult, especially in noisy environments or when trying to locate where sounds are coming from.

Most cases of single-sided deafness are sensorineural in nature, which means that your hearing loss is caused by damage to the hair cells in your inner ear.

Living with single-sided deafness

There are some challenges unique to single-sided deafness. These include:

The ‘head shadow’ affect, which is the reduced ability to hear sounds originating from the deaf side. This is because your head physically blocks sound waves, especially high-frequency ones, from being heard in your working ear. As a result, sounds may sound muffled because you can’t register high-frequency sounds such as ‘s’ or ‘f’.
Sound localisation, which is the ability to pinpoint where a sound is coming from. This is because you identify the source of a sound by which ear hears it first; this is not possible if you are deaf in one ear.
Being unable to tell how loud a sound is. This is because your brain perceives the volume of a sound more accurately when both ears receive input.
Disorientation in noisy environments, because your brain is less able to filter out irrelevant noises with only one ear.

What causes single-sided deafness?

There are various reasons why someone might develop single-sided deafness. This includes:

Meniere’s disease – an inner ear condition that affects balance and hearing
acoustic neuroma
traumatic brain injury
viral or bacterial infections
physical damage to the ear
noise-induced hearing loss
circulatory system disorders
genetic or inherited disorders, including neurofibromatosis type 2

Sometimes, there is no apparent cause for developing single-sided deafness.

Single-sided deafness that comes on suddenly (called sudden sensorineural hearing loss) is not normal and should be investigated and treated as an emergency. Depending on the cause and how quickly it is treated, there is a good chance of a full recovery.

Single-sided deafness symptoms

The symptoms of single-sided deafness are typically the same as that of hearing loss in both ears. This includes:

difficulty following conversations, particularly in noisy environments
frequently asking people to repeat themselves
turning up the volume on your TV or mobile phone louder than usual
difficulty hearing on the phone
experiencing ringing in your ears (tinnitus)
fatigue from the increased concentration required to listen
social withdrawal and anxiety

Cochlear implant for single-sided deafness

What are cochlear implants?

A cochlear implant is an electronic device that helps to stimulate the auditory nerve, providing the sensation of sound in patients with deafness or profound hearing loss in one or both ears. They have been found to be beneficial in improving sound localisation and speech understanding in people with single-sided deafness.

Cochlear implants only work for patients with sensorineural hearing loss, which is the most common type. Sensorineural hearing loss occurs in the inner ear.

The ear is made up of three parts: outer, middle, and inner. The inner ear contains the cochlea, a small, fluid-filled structure. Sound waves cause this fluid to vibrate, triggering the hair cells (which line the cochlea) to produce electrical impulses. These impulses travel to the brain via the auditory nerve, where they are interpreted as sound.

If your hair cells are damaged, they will not be able to convert sound waves into electrical impulses. In people with mild hearing loss, hearing aids are used to amplify the sound waves so that they can be converted. This is not possible in people who are deaf or who have profound hearing loss.

How do cochlear implants work?

A cochlear implant is composed of an external and internal part. The external part of the cochlear implant (also referred to as the ‘sound processor’) is small disc-shaped device worn on the head, which picks up sounds and converts them into electrical signals.

The signals are received via the internal part of the implant, which is placed under the scalp. The internal implant converts these signals into electrical currents, which are then passed down an electrode in the cochlea to stimulate the auditory nerve. The auditory nerve sends signals to the brain, which are interpreted as sound.

How do cochlear implants work?

Benefits of cochlear implants for single-sided deafness

The benefits of cochlear implants for single-sided deafness include:

enhanced speech understanding, particularly in noisy environments
improved sound localisation, allowing patients to better determine where sounds are coming from
reduction in tinnitus, with some patients experiencing a significant reduction in, or even the complete elimination of, this symptom
improved quality of life, with patients experiencing better social interactions, reduced listening effort, and increased confidence
restoration of binaural hearing (hearing in both ears), allowing for a more natural and balanced hearing experience

Cochlear implants at Garrick Hospital

The cochlear implant programme at Garrick Hospital is available for adult patients with unilateral or bilateral sensorineural hearing loss.

The programme includes:

a comprehensive initial assessment, with hearing tests (audiometry), speech tests, balance tests, and videonystagmography (a test that evaluates your eye movements)

the surgical implantation of your cochlear implant(s), performed by leading ENT surgeon Mr David Selvadurai

a 12-month follow-up package with an audiologist, to help calibrate your device and track your progress

If you are paying for yourself, please contact our dedicated Self-Pay team on 020 7244 4886.

If you are intending on using private medical insurance, please check with your insurer that this is covered before booking an appointment.

For more information about the programme and surgical procedure, please visit our dedicated webpage.

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Keyhole heart surgery: Benefits for patients

P White — Tue, 06 May 2025 14:53:19 +0000

Being diagnosed with a condition that requires cardiac surgery can be a worrying prospect for many people. Often, the thought of heart surgery is quickly followed by those of broken breastbones and prolonged recovery times.

Fortunately, following years of advancements in the field of cardiac surgery, a keyhole approach is a safe and effective alternative for many patients, allowing them to recover and return to normal life faster. In this blog, we explore common queries surrounding keyhole heart surgery, as well as the treatment options available at Garrick Hospital.

What is keyhole heart surgery?

Traditionally, in order to reach the heart during open-heart surgery, surgeons will carry out a procedure called a sternotomy, which involves opening up the breastbone (sternum). While effective in gaining access to the heart, this method is associated with longer recovery times and an increased rate of complications for patients.

For eligible patients, the alternative is keyhole (minimally invasive) heart surgery. This is a technique where, instead of opening up the breastbone, the heart is accessed through the ribs via small, strategically placed cuts (incisions). For many patients, this results in much faster recovery times and a reduced rate of complications.

Surgeons who provide keyhole heart surgery are specially trained to do so. At Garrick Hospital, Mr Inderpaul Birdi, Consultant Cardiac Surgeon, holds over 35 years’ experience in cardiac surgery and is internationally recognised for advancing minimally invasive techniques.

Benefits of keyhole heart surgery

There are many reasons why eligible patients opt for keyhole heart surgery:

Faster, easier recovery – Many patients who undergo minimally invasive surgery are able to resume normal activities faster than those who underwent open-heart surgery. This includes moving around sooner, returning to hobbies and work, and generally feeling better.
A shorter hospital stay – Patients who undergo keyhole heart surgery are usually able to go home sooner than their open-heart counterparts.
Less bleeding – This reduces the risk of requiring a blood transfusion, which can occasionally present with complications.
Reduced risk of wound infection – Cardiac surgery carries a higher risk of wound infection than other types of surgery. A wound infection can prolong patient recovery, so it is important to avoid this outcome where possible.
Less scarring – Scarring from keyhole heart surgery is typically more discreet due to the method used for accessing the heart.
Reduced anxiety – Many patients feel more comfortable and optimistic about their surgery knowing that they won’t have to undergo a sternotomy.

Types of keyhole heart surgery

Keyhole mitral valve repair or replacement

The mitral valve is a small, flap-like structure located between the left atrium and left ventricle (the left-hand chambers) within your heart. It controls the direction of blood flow between these chambers and prevents blood from flowing the wrong way.

There are two primary conditions that affect the mitral valve: regurgitation, where blood 'leaks' backwards into the left atrium, and stenosis, where the valve stiffens and blood flow is restricted.

The heart is accessed via a small incision made between the ribs on the right side of the chest. Typically, this wound will heal within seven to 10 days following surgery.

Robotic technology, such as the da Vinci, is not used as standard for minimally invasive mitral valve repair. This is because an equally excellent result can be achieved faster by hand, reducing the amount of time patients spend on equipment like the heart lung machine (cardiopulmonary bypass machine).

Keyhole aortic valve replacement

The aortic valve is a flap-like structure that controls blood flow from the left ventricle to the body’s main artery (the aorta). Like the mitral valve, the aortic valve can also suffer from regurgitation and stenosis, resulting in the need for surgical repair.

Typically, the heart is accessed via a small incision made between the ribs on the right side of the chest. Very rarely, the surgeon may need to instead divide a very small portion of the breastbone (called a ministernotomy).

We offer a procedure called a sutureless aortic valve replacement (AVR), where the replacement valve does not require stitching into position. It is particularly beneficial for high-risk patients as the valve can be placed faster, reducing the risks associated with surgery.

Keyhole heart bypass surgery

Heart bypass surgery is also referred to as a coronary bypass, CABG (which stands for coronary artery bypass graft), or triple/quadruple bypass (depending on the amount of bypass grafts carried out). It is carried out in patients who have narrowed arteries, to improve blood flow.

Minimally invasive coronary bypass surgery is called MIDCAB (minimally invasive direct coronary artery revascularisation). This procedure involves attaching a donor blood vessel onto the coronary artery located above and below the narrowed portion. MIDCAB is a preferable long-term alternative to stenting, which is less invasive but can become blocked over time.

Some patients may require surgery across multiple blood vessels. Garrick Hospital is one of only hospitals worldwide to provide multi-vessel minimally invasive coronary surgery – which is more formally known as total coronary revascularisation by anterior thoracotomy (TCRAT). This procedure is carried out by Mr Inderpaul Birdi, who performed the UK’s first quadruple heart bypass via keyhole surgery in 2022. Over the past few years, patients have received triple and quadruple bypasses via keyhole surgery at Garrick Hospital.

One of the benefits of MIDCAB is that it can be performed as a beating heart surgery (also known as off-pump surgery). This is, as it sounds, when a procedure is carried out with the heart still beating, as opposed to putting the patient on a heart-lung machine. Beating heart surgery carries a lower risk of complications, such as heart muscle damage, as it is less stressful on the body.

Keyhole surgery for atrial fibrillation

Keyhole surgery may be a preferential option for atrial fibrillation patients who have not seen success with catheter ablation, because it allows for a more visually guided and thorough treatment approach.

The heart is accessed via small surgical incisions on either side of the chest, and a small clamp is placed to isolate the pulmonary veins from the left atrium (where the abnormal electrical signals originate). This interruption of abnormal electrical signals prevents the occurrence of further arrhythmic episodes.

Patients with paroxysmal atrial fibrillation (intermittent episodes) do not require the use of a heart-lung machine, although more complex and persistent cases will if they are undergoing a specific treatment known as the Maze procedure.

Keyhole ASD closure

An atrial septal defect (ASD) is a congenital (present at birth) condition where a hole is located between the two upper chambers of the heart. Left untreated, ASD can have severe complications such as heart failure and lung damage. Treatment involves closing the hole, which can be done using the keyhole technique.

Keyhole heart surgery FAQs

Who is suitable for keyhole heart surgery?

There is no defined age limit for keyhole heart surgery, so eligibility will largely depend on your overall health. This will be determined following a thorough consultation with a cardiac surgeon. Some patients, such as those with complex or severe heart disease, may require the improved exposure granted by a traditional open-heart approach.

If you have not done so already, you will also need to undergo certain diagnostic and imaging procedures (echocardiogram, ECG, coronary angiogram, and/or CT scan) so that we can better assess your suitability for surgery.

What is the success rate of keyhole heart surgery?

The success rates for keyhole heart surgery are comparable to – and, in some cases, higher than – traditional open-heart surgery. For the best outcome, you should ensure that your surgeon and their team are experienced in carrying out keyhole techniques.

How long does it take to recover from keyhole heart surgery?

One of the greatest benefits of keyhole heart surgery is the faster, easier recovery time when compared to traditional open-heart surgery. Many keyhole patients will be moving around within days of surgery and return to their normal routine within around three weeks. In comparison, open-heart patients have a standard recovery time of three months.

What are the risks of keyhole heart surgery?

Keyhole heart surgery is not without its risks, although many of these are minimised or eliminated entirely when compared to open-heart surgery. Although rare, the risks of keyhole surgery may include bleeding, infection, blood clots, heart attack, stroke, and damage to surrounding organs. At Garrick Hospital, our experienced surgical team are well-equipped to manage any unexpected complications of keyhole heart surgery.

How long does keyhole heart surgery take?

The length of keyhole heart surgery depends on the procedure being carried out. Generally, this could take anywhere from one to three hours.

How much does keyhole heart surgery cost?

If you are self-funding your keyhole heart surgery, please contact our dedicated Self-Pay team on 020 7244 4886.

Our friendly advisors will be able to explain more about how self-pay works, how much it costs, and answer any questions you might have.

About Mr Inderpaul Birdi

Mr Inderpaul Birdi is a highly experienced and world-renowned cardiac surgeon, founder of The Keyhole Heart Clinic, and member of the Heart Partners specialist group at Garrick Hospital. With over 35 years' experience in the field of cardiac surgery, he is one of very few surgeons worldwide who can carry out keyhole coronary bypass surgery and keyhole aortic valve repair.

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Hypertension and renal denervation

P White — Fri, 04 Apr 2025 09:43:14 +0000

According to the World Health Organization, an estimated 46% of adults with hypertension don't realise they have the condition. This is because hypertension doesn’t typically present with symptoms until it has reached a critical stage. 1 in 3 adults will develop hypertension during their life.

Uncontrolled hypertension can lead to serious health problems, including strokes, heart attacks, heart failure, kidney failure, visual impairment and more – which is why it’s important to have your blood pressure checked regularly. Find out more about hypertension and renal denervation, an advanced solution for treatment-resistant cases, in this blog.

What is hypertension?

Hypertension, also known as high blood pressure, is when the force of your blood against the walls of your arteries (the tubes that carry blood around the body) is too high. It’s a common condition, especially in older adults, but it can lead to serious health problems if left untreated.

Throughout the day, your blood pressure naturally goes up and down – particularly if you’re active – and your arteries stretch to compensate for this. However, if your blood pressure is high when resting, this is a cause for concern.

When you have high blood pressure, your arteries can stiffen which makes it easier for fatty deposits to build up within them. This is what can eventually lead to serious complications, such as heart attacks and strokes.

Symptoms of hypertension

Often, symptoms of hypertension won’t occur until the condition has reached a severe or life-threatening stage. These include:

headaches
blurred vision
chest pain

How is hypertension diagnosed?

You can have your blood pressure checked at your GP practice or a dedicated hypertension clinic.

Blood pressure is measured using an electric monitor connected to an inflatable cuff, which is placed around the upper arm. You will receive two numbers:

systolic pressure (the higher number) – the pressure against your arteries when your heart is pumping blood around your body
diastolic pressure (the lower number) – the pressure in your arteries when your heart relaxes between beats

To diagnose hypertension, you will need your blood pressure measured more than once; this is because blood pressure fluctuates throughout the day. You may be provided with a blood pressure monitor to use at home, or a 24-hour monitor (called ambulatory blood pressure monitoring) that checks your blood pressure throughout the day. A clinician will look at your results to determine your average blood pressure.

Depending on your results, you may be advised to have further diagnostic tests, such as an ECG or echocardiogram, to rule out additional causes.

Stages of hypertension

There are several stages of hypertension:

normal – where blood pressure is between 90/60mmHg and 120/80mmHg
elevated or ‘prehypertension’ – where blood pressure levels are consistently between 120 and 129mmHg systolic and less than 80mmHg diastolic
stage 1 – where blood pressure levels are consistently between 130 and 139mmHg systolic or 80 to 89 mmHg diastolic
stage 2 – where blood pressure is consistently at or above 140/90mmHg
stage 3 or ‘hypertension crisis’ – where blood pressure is consistently at or above 180/120mmHg

Treatment depends on the grading of your hypertension. Stage 1 hypertension can often be managed with lifestyle changes, while stage 2 will also require medication. Stage 3 requires immediate medical attention.

Renal denervation for hypertension

Renal denervation is an advanced interventional therapy recommended for patients who have treatment-resistant hypertension or who cannot tolerate medication due to side effects. It works by reducing the activity of nerves surrounding the renal arteries that contribute to high blood pressure.

The renal arteries supply blood to your kidneys; inside the wall of these arteries are nerves that help control blood pressure. When these nerves are overactive – as they often are in treatment-resistant hypertension patients – they can contribute to hypertension.

A small incision is created in the groin so that a catheter (a thin, flexible tube) can be inserted and guided into the renal arteries. Heat energy is then delivered through the catheter to neutralise the hyperactive nerves that contribute to hypertension. The procedure lasts around an hour, and most patients will be discharged the same day.

Benefits of renal denervation

As well as effectively lowering blood pressure long term, renal denervation patients can also benefit from:

Reduced reliance on medication – Over time, some patients may find their reliance on medication is reduced, or that they don’t need as many medications as before.
Enhanced existing medications – Some patients may find that their existing medications perform more effectively following renal denervation.
Reduced risk of cardiovascular disease – Patients are less likely to develop serious conditions such as heart attacks and strokes.

Renal denervation at Garrick Hospital

At Garrick Hospital, renal denervation is provided by Dr Sayan Sen and his specialist cardiac group One Heart Clinic.

Dr Sen is an internationally renowned cardiologist specialising in the assessment and management of patients with hypertension.

One Heart Clinic is a specialist group comprising of over 25 cardiologists who work collaboratively to deliver the best cardiac care for you and your heart.

To enquire about renal denervation, please contact Garrick Hospital’s Self-Pay team on .

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Patient testimonial: Thumb CMCJ replacement surgery

P White — Mon, 03 Mar 2025 12:00:14 +0000

Arthritis is a common condition that causes pain and inflammation in a joint. In the UK, millions of people have arthritis or other, similar conditions that affect the joints.

Arthritis can cause joint pain, swelling, and restriction of movement, and symptoms can sometimes have a debilitating effect on people’s life.

Diagnosing thumb pain

When Ms Levestam-Smart was experiencing pain in her thumbs, she visited Mr Ravi Mallina, Consultant Orthopaedic Hand and Wrist Surgeon at Garrick Hospital, for diagnosis and support.

“I saw Mr Ravi Mallina about pain I had been having in both of my thumbs for over a year. The pain was constant and worsened on activities such typing, opening jars, or carrying items. It was having a severe impact on my daily life, in particular my work. Mr Ravi quickly diagnosed the issue and then went through my options very clearly. I chose the CMCJ replacement surgery for my left thumb.”

Mr Mallina diagnosed her with arthritis in the thumbs, and recommended thumb CMCJ replacement surgery.

Undergoing treatment

Thumb CMCJ (carpometacarpal joint) replacement surgery, also known as thumb base joint replacement, involves replacing the arthritic joint at the base of the thumb with an artificial joint to relieve pain and improve function.

Mr Mallina said: "After I assessed Ms Levestam-Smart, I went through her options, and recommended thumb CMCJ replacement surgery, as it would offer her pain relief and return of mobility to her thumb join. CMCJ surgery requires me to remove and replace arthritic joint, which in this case was the trapezium bone, with an artificial joint."

Following her procedure, Ms Levestam-Smart said: "The surgery was very quick and I went home on the same day. I had bandages and a sling for the first 14 days and then I had the stitches removed. I already had good movement in my thumb and was able to perform the required thumb exercises."

Recovering from surgery

Of her recovery period, Ms Levestam-Smart said: "Within three weeks from the surgery, I was able to fully return to work with almost no pain. I have had three physio appointments and have been nearly pain free from six weeks after surgery."

"Mr Ravi and his team have been very supportive and made me feel very relaxed about having the procedure. The pain management provided was excellent, as has been the physio. I am delighted with the surgery, and with Mr Ravi and team. After suffering all those months, it seems incredible to have had such an excellent result so quickly."

Mr Ravi added: "I am delighted to have been able to help Ms Levestam-Smart and that she has had a good recovery."

Orthopaedic care at Garrick Hospital

Our consultant orthopaedic surgeons provide world-class care and treatment for patients with conditions affecting their joints, bones, ligaments, tendons, muscles, and nerves.

Mr Ravi Mallina, Consultant Orthopaedic Consultant, is a highly skilled and experienced Consultant Hand and Wrist Surgeon offering treatment within a multi-disciplinary team comprising of therapists, rheumatologists, anaesthetists and radiologists. He is known for his expertise in treating complex hand and wrist conditions.

Discover orthopaedic care at Garrick Hospital >

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Navigating the slopes: Understanding ACL injuries in skiing

P White — Mon, 03 Mar 2025 11:48:13 +0000

Mr Raghbir Khakha is a world-leading expert in sports injuries and shares his insights on knee injuries and skiing.

Statistics show that three injuries happen per 1,000 skiers with knee injuries accounting for 30 to 40% of all injuries.

What is the ACL?

Anterior cruciate ligament (ACL) injuries are a common sporting knee injury.

Your ACL is a band of tissue that runs through the middle of your knee joint. It attaches your thigh bone to your shin bone and is responsible for preventing excessive forward movement of your tibia against your femur.

Most ACL injuries occur during sports that involve sudden changes in direction, but they can also be caused by excessive bending or straightening of the leg, landing incorrectly when jumping, or an acute injury (such as a fall or blow).

Typically, patients describe a pop in the knee which is sensitive for an ACL rupture. Up to a quarter will have an associated meniscal or associated ligament injury. 

Skiing ACL injuries

The incidence of ACL injuries linked to skiing is close to 30%. Often, ski ACL injuries occur when the skier falls and twists their knee, such as when ski bindings do not release.

ACL injuries affect all ages but is more common in female patients. The reasons why it is more common in female patients, is similar to that seen in women’s sport in general.

How to manage an ACL injury

Managing the swelling early has been shown to reduce knee pain, improve quadriceps function, and improve time to recovery. This can be done utilising multiple methods including ice, physiotherapy, and physically removing the fluid from the knee in clinic. 

A multidisciplinary approach with physiotherapists helps to restore range of movement and reduce swelling and, in up to 30% of patients, can help reduce instability symptoms and manage non-operatively.

In adolescents, athletes, and professional sports people, it’s an important structure to preserve knee biomechanics and often requires surgery in these groups. If there is an associated ligament injury, then a brace may be required to allow the associated ligament to heal before intervening. 

Most patients are suitable for an ACL reconstruction, where a quadriceps tendon, hamstring tendon, or patella tendon can be used to replace the torn ACL – and, in rare circumstances, the patient’s own ACL may be amenable to repair. 

To find out the latest prices for ACL surgery at Garrick Hospital, please visit our dedicated page.

Call us today on >

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