Andrea from Cypress, TX sent us this question: “I have a sliding hiatal hernia and acid reflux. My surgeon wants to repair my hiatal hernia and add LINX metal ring for severe acid reflux. I am concerned about LINX safety. I already have gastroparesis and my vagus nerve has already been damaged. Should I even consider this surgery?”
Nissen fundoplication and hiatal hernia repair is a more reliable treatment for acid reflux disease when compared to LINX device placement. In addition, fundoplication surgery promotes gastric emptying. Therefore, in cases of concomitant GERD and gastroparesis, I recommend Nissen fundoplication over LINX device implantation. I have treated several LINX patients who presented to my office with gastroparesis after LINX implant surgery. Corrective surgery entailed LINX device removal, and conversion to Nissen fundoplication. A concomitant partial gastrectomy is added depending on the severity of gastroparesis.
For mild gastroparesis cases, Nissen fundoplication surgery is enough to cure GERD and gastroparesis. For moderate or severe gastroparesis, I add a partial gastrectomy along the greater curvature to further promote gastric emptying. I have had great success using this approach.