Mr Hemanshoo Thakkar — Consultant Paediatric Surgeon, London

Conditions treated

Clear answers for worried parents.

A plain-English guide to the conditions Mr Thakkar treats most often — what they are, how they’re diagnosed, and the options available. Tap any condition to read more. This is general information for parents and carers, not a substitute for medical advice.

Tongue tie anatomy — tongue, frenulum and floor of mouth — Anatomy of tongue tie: the lingual frenulum tethering the underside of the tongue to the floor of the mouth.

What is it?

Tongue tie (ankyloglossia) is a condition present from birth in which the strip of tissue connecting the underside of the tongue to the floor of the mouth — called the lingual frenulum — is shorter, tighter, or thicker than usual, restricting the normal range of movement of the tongue. It is relatively common, affecting approximately 4–11% of newborns, and is more frequently seen in boys. The degree of restriction varies: some children have a mild, barely noticeable tie, while in others it can significantly limit tongue function.

How is it diagnosed?

Tongue tie is usually identified shortly after birth by a midwife, health visitor, or lactation consultant. Diagnosis is clinical — a healthcare professional examines the frenulum and assesses tongue mobility using one of several validated scoring tools. Key signs include difficulty latching during breastfeeding, clicking sounds while feeding, poor weight gain, and nipple pain or damage in the breastfeeding parent. Older children may present with speech difficulties or an inability to lick their lips.

Treatment options

Watchful waiting — mild cases with no feeding difficulties may resolve on their own as the child grows.
Frenotomy — a quick, simple procedure in which the frenulum is snipped with sterile scissors. No anaesthetic is required in newborns; it takes only seconds and most babies feed immediately afterwards.
Frenuloplasty — a more involved surgical procedure under general anaesthetic, used for thicker or posterior tongue ties, or in older children where a simple snip is insufficient.
Speech and language therapy — recommended alongside or instead of surgery in older children where the primary concern is articulation.

What is it?

An inguinal hernia occurs when part of the intestine — or, in girls, an ovary — pushes through a weakness in the abdominal wall into the inguinal canal, the passage in the groin through which, in boys, the testicles descend before birth. In children it is almost always caused by a patent processus vaginalis: a small sac of peritoneum that should close naturally around birth but remains open. Inguinal hernias are far more common in boys (roughly a 9:1 male-to-female ratio) and are seen most often in premature infants. Unlike in adults, they do not resolve on their own and always require surgical repair.

How is it diagnosed?

Parents typically notice an intermittent bulge in the groin or scrotum, most apparent when the child cries, coughs, or strains, which usually disappears when the child is calm and lying down. Diagnosis is made clinically by a doctor, who will feel for the hernia and may ask the child to cough or bear down. An ultrasound scan may be used if the diagnosis is uncertain or to assess the contents of the hernia sac.

Important If the bulge becomes hard, red, or painful and cannot be pushed back in, this is an incarcerated hernia — a medical emergency requiring immediate attention.

Treatment options

Open surgery — traditionally performed through a small groin-crease incision; a well-established, reliable approach.
Laparoscopic (keyhole) repair — increasingly used, particularly when a hernia on the opposite side needs to be checked for at the same time.
Emergency reduction — if a hernia is incarcerated, a surgeon may attempt to gently push the contents back before proceeding to planned repair.

What is it?

An umbilical hernia is a protrusion of abdominal contents — usually a small amount of fatty tissue or bowel — through a weakness in the muscles around the navel. After birth the umbilical ring normally closes; if this closure is incomplete or delayed, a hernia can develop. They are very common in newborns, particularly premature babies and those of African descent, appearing as a soft, rounded swelling at the belly button that becomes more obvious when the child cries or strains. The vast majority close spontaneously during the first few years of life without any intervention.

How is it diagnosed?

The diagnosis is usually made by a GP or paediatrician during a routine examination. The characteristic soft bulge at the navel — which reduces easily when pressed and enlarges with crying — is immediately recognisable. Ultrasound is rarely required but may be used to confirm the diagnosis in unclear cases or to assess hernia contents.

Treatment options

Observation — most umbilical hernias close on their own by age 3–4. Surgery is generally not considered before this age unless complications arise.
Surgical repair — recommended if the hernia persists beyond age 4–5, is enlarging, has a defect wider than 1.5 cm, or causes symptoms. Performed under general anaesthetic through a small incision hidden in the belly-button fold.
Emergency repair — very rarely required, as strangulation of an umbilical hernia in children is uncommon but possible if the hernia becomes painful and irreducible.

What is it?

During normal development the testes form in the abdomen and gradually descend through the inguinal canal into the scrotum before birth. In some boys this process is incomplete, leaving one or both testes in the abdomen or inguinal canal at birth — known as cryptorchidism. It affects approximately 2–5% of full-term male newborns and up to 30% of premature boys. Spontaneous descent often occurs within the first 3–6 months of life; descent after 6 months is unlikely without treatment. An undescended testis is associated with a higher risk of reduced fertility and testicular cancer in later life if left untreated, which is why early correction is recommended.

How is it diagnosed?

All male newborns are examined for testicular position as part of the newborn infant physical examination (NIPE), and again at the 6–8 week check. The scrotum is inspected and palpated to determine whether each testis can be felt. A testis is classified as palpable (felt in the groin or at the scrotal entrance) or impalpable (suggesting it lies in the abdomen or, rarely, is absent). Ultrasound has limited reliability for locating impalpable testes; MRI or diagnostic laparoscopy may be used to confirm the position of a testis that cannot be felt.

Treatment options

Watchful waiting — appropriate in the first 6 months of life, as spontaneous descent may still occur.
Orchidopexy — the standard surgical treatment, in which the testis is brought down into the scrotum and secured in place. Recommended by 12–18 months; early surgery preserves fertility potential and allows self-examination in adulthood.
Laparoscopic assessment and orchidopexy — used for impalpable testes to locate the testis inside the abdomen and bring it down, sometimes in two stages if the blood supply is limiting.

What is it?

Phimosis is a condition in which the foreskin (prepuce) cannot be fully retracted behind the head of the penis (glans). Physiological phimosis is entirely normal in infants and young boys — the foreskin is naturally non-retractile at birth and in the vast majority of boys it loosens over childhood and adolescence without intervention; forcible retraction should never be attempted. Pathological phimosis develops later, usually due to scarring from balanitis xerotica obliterans (BXO) — a progressive skin condition that causes a white, inelastic ring to form at the tip of the foreskin, preventing retraction and sometimes causing pain, ballooning on urination, or recurrent infections.

How is it diagnosed?

Diagnosis is clinical. A GP or paediatric surgeon will examine the foreskin and assess whether non-retractability is physiological (normal for age) or pathological (associated with scarring, whitening, or symptoms). Indicators of pathological phimosis include a white, scarred ring at the tip of the foreskin; pain or bleeding on attempted retraction; difficulty or pain passing urine; recurrent balanitis; or a urinary stream that is weak or sprays.

Treatment options

Reassurance and watchful waiting — the correct approach for physiological phimosis in children under 10, as spontaneous resolution is expected.
Topical steroid cream — a first-line treatment for pathological phimosis without severe scarring. A mild steroid cream (e.g. 0.1% betamethasone) applied twice daily for 4–8 weeks can significantly improve or resolve phimosis in many cases.
Circumcision — surgical removal of the foreskin, recommended when topical treatment has failed, when BXO is confirmed, or when there is significant urinary obstruction. It is curative and gives the most reliable long-term outcome.
Preputioplasty — a foreskin-sparing alternative in which the tight ring is widened surgically, preserving the foreskin. Suitable for selected cases where scarring is limited.

Pilonidal sinus disease — sinus tract, skin opening and hair follicles in the natal cleft — Pilonidal sinus disease: a sinus tract opening at the skin of the natal cleft, associated with embedded hair follicles.

What is it?

A pilonidal sinus is a small channel or pit in the skin, most commonly in the natal cleft — the groove between the buttocks, just below the tailbone. It is thought to occur when loose hairs penetrate the skin and become embedded, triggering chronic inflammation and forming a sinus tract under the skin. It predominantly affects teenagers and young adults and is more common in males, those with a deep natal cleft, coarse dark hair, and those who sit for long periods. Severity ranges from an asymptomatic pit found incidentally to a painful abscess requiring emergency drainage, with many patients experiencing recurrent swelling, pain and discharge between flares.

How is it diagnosed?

Diagnosis is clinical. A surgeon or GP will inspect the natal cleft for characteristic pit openings in the midline, often with surrounding redness, swelling, or a discharging sinus, and there may be visible hair protruding from the opening. Imaging is not usually required for straightforward cases; an MRI or ultrasound may occasionally be used to map complex or recurrent disease before surgery, or to distinguish it from an anal fistula or perianal abscess.

Treatment options

Mr Thakkar offers EPSiT — Endoscopic Pilonidal Sinus Treatment, a minimally invasive, day-case option particularly well suited to younger patients.

Conservative management — meticulous hair removal from the natal cleft (shaving or laser), good hygiene, and weight management can prevent flares in mild disease and reduce recurrence after surgery.
Incision and drainage — performed under local or general anaesthetic when an acute abscess is present. It relieves pain and infection rapidly but does not address the underlying sinus, so recurrence is common.
Pit picking (Gips procedure) — a minimally invasive technique for simple disease without a large abscess cavity. The sinus pits are excised through tiny incisions and recovery is rapid — well suited to younger patients with limited disease.
Endoscopic Pilonidal Sinus Treatment (EPSiT) — a minimally invasive technique using a camera to visualise the tracts, then clean and debride the pits. Well suited to young patients with limited or more extensive disease.
Wide excision — removal of the entire sinus and surrounding tissue, with the wound either left open to heal naturally (slower but lower recurrence) or closed primarily. Open healing requires regular dressing changes.
Flap procedures (Karydakis, Bascom cleft lift) — for recurrent or complex disease, the natal cleft is flattened and tissue rearranged with a flap to reduce its depth — the key risk factor for recurrence. These offer the best long-term outcomes for difficult disease.

This information is a general guide for parents and carers and does not constitute medical advice. Always consult your GP or paediatric surgical team for advice specific to your child.

In their words

Trusted by families across London.

4.99

★★★★★

Verified Doctify reviews · providers can’t edit or remove

“

Inguinal & Paediatric Hernia

We cannot fault the care our 6-week-old son received, from first consultation right through to aftercare. The communication meant he got his surgery as quickly as possible. We never doubted our baby was in the safest hands.

Verified patientMay 2026

Umbilical Hernia · Age 15

Dr Thakkar gave a brilliant explanation of the surgery and spoke to us afterwards too. He really understood that my daughter just wanted to feel normal. His work was outstanding and her confidence has already improved — I can’t thank him enough.

Verified patientFebruary 2026

Tongue Tie

He was incredibly thorough in explaining all the details and risks, which eased my worries as a first-time mum. Despite a last-minute appointment, he made room to see us quickly — true dedication and compassion.

Verified patientMarch 2026

Hernia

I want to express my heartfelt gratitude to Dr Thakkar for the care and attention given to my child. He was professional, attentive and explained everything clearly. Overall a wonderfully positive experience.

Hernia · The Portland

We waited a long time for my three-year-old’s surgery, and the staff took such good care of us — no stress at all. As a mum that reassurance was so important. Smooth, quick recovery. We felt completely blessed.

Endorsement · Fellow Surgeon

Hemanshoo is a fantastic surgeon with deep knowledge and expertise in his field. I fully endorse him for any parents worried about their child who want an expert opinion and care.

Mr Pranab SinhaOrthopaedic Surgeon

A clinician shaped by great institutions — and a genuine love of children’s care.

Specialist surgery, gently delivered.

Tongue Tie

Hernia Repair

Anorectal Anomalies

Laparoscopic (Key-Hole)

Undescended Testes & Hydrocoele

Pilonidal Sinus Disease

Clear answers for worried parents.

What is it?

How is it diagnosed?

Treatment options

What is it?

How is it diagnosed?

Treatment options

What is it?

How is it diagnosed?

Treatment options

What is it?

How is it diagnosed?

Treatment options

What is it?

How is it diagnosed?

Treatment options

What is it?

How is it diagnosed?

Treatment options

Trusted by families across London.

Consulting at London’s finest hospitals.

The Portland Hospital

Outpatient 84 Harley Street

Evelina London Children’s Hospital

St Thomas’ Hospital

Guy’s & St Thomas’ Private Healthcare

Languages spoken

Advancing the field, publishing the evidence.

Parental attitudes to neoanus dilatations post-reconstruction in anorectal malformations (PANDA) study

Quantifying the impact of congenital cardiac co-morbidities on anorectal malformations

Long-term outcomes of botulinum toxin injection into the external anal sphincters: a new treatment of chronic functional constipation in children

Late diagnosis of anorectal malformation: how good is good enough?

Consultation fees

Ready to take the next step for your child?