Chronic gastroesophageal reflux disease (GERD), when not responsive to therapy, can progress to serious complications including precancerous Barrett’s esophagus and esophageal cancer. Symptoms are often debilitating and may include daily pain, difficulty swallowing, and sleep disruption. The disease is also associated with upper respiratory problems including asthma and bronchitis/pneumonia. Medical therapy (acid suppression medications) commonly prescribed to address GERD symptoms do not address the underlying cause of the disease, which is a weak sphincter (valve) between the stomach and esophagus.
C. Daniel Smith, MD, professor of surgery, Mayo Clinic, in Jacksonville, Fla, recently published his experience with the LINX Magnetic Sphincter Augmentation System in the Journal of the American College of Surgeons. “Our clinical experience with the LINX System matches what has been observed in controlled trials. Importantly, we are seeing LINX as a new treatment option for patients who suffer from GERD despite continuous drug use. The ability to offer patients a minimally invasive treatment which restores their esophageal sphincter without major side effects has been a long-term clinical need which it appears LINX can fulfill,” Smith says.
Linx is a small implant comprised of interlinked titanium beads with magnetic cores. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent reflux. The device is implanted using a standard minimally invasive laparoscopic procedure and is an alternative to the more anatomically disruptive fundoplication, commonly used in surgical antireflux procedures. The Linx Reflux Management System is indicated for those patients diagnosed with GERD as defined by abnormal pH testing, and who continue to have chronic GERD symptoms despite maximum medical therapy for the treatment of reflux.
A second study, recently published in the Annals of Thoracic Surgery, presents Linx outcomes by Brian Louie, MD, director, Thoracic Research and Education and colleagues from the Swedish Cancer Institute and Medical Center in Seattle. The team evaluated sphincter augmentation with Linx with case matched sphincter reconstruction using the patient’s gastric fundus (Nissen fundoplication). Study results demonstrated that both Linx and fundoplication provided significant improvement in GERD symptoms such as heartburn, regurgitation, and cough. However, patients implanted with Linx had a greater ability after the procedure to belch and experienced less bloating and gassy feelings, which are commonly associated with laparoscopic Nissen fundoplication surgery.
“The LINX device appears to restore the sphincter barrier function and preserve normal physiology, which enables belching and vomiting,” says Louie. “Linx is an important new surgical treatment option for patients who fail medical therapy and have worsening GERD.”