Gastroparesis after LINX Removal Surgery

Gastroparesis after LINX Removal Surgery

Indications to remove LINX device for acid reflux are numerous:

  1. Erosion
  2. Dysphagia
  3. Recurrent hiatal hernia
  4. Recurrent acid reflux
  5. Poor heartburn control
  6. Chest pain

Surgery for LINX device removal is performed through tiny incisions. Most of the time the same incisions used to place LINX device are used to remove it. As a foreign body, LINX device triggers scar tissue formation around the lower esophageal sphincter and both posterior and anterior vagus nerves. Scar tissue dissection to free LINX device and remove may result in vagus nerve injury. Vagus nerve injury is associated with gastroparesis development.

Gastroparesis or delayed gastric emptying is a debilitating disease. Gastroparesis patients have a lazy or paralyzed stomach that does not empty food. Symptoms associated with gastroparesis including nausea, vomiting, pain, early satiety and bloating. Gastroparesis exacerbates acid reflux leading to increased heartburn, food regurgitation, and sore throat.

Typically, LINX device removal is coupled by hiatal hernia repair and Nissen fundoplication to control acid reflux disease. If you had LINX device removal and conversion to Nissen fundoplication and you currently suffer from gastroparesis we may be able to help you.

At Houston Heartburn and Reflux Center, we do not offer LINX surgery for acid reflux disease. However, we have developed a simple and safe solution to get rid of post-LINX device removal gastroparesis without disrupting the Nissen fundoplication. A small stomach resection along the lateral aspect of the stomach is performed to promote gastric emptying. The resection is limited to the area between the gastric antrum and fundoplication resulting in 30% of the stomach removed. The surgery is minimally invasive and associated with overnight hospital stay and fast recovery.

Our preliminary results have been excellent with complete symptom resolution and normalization of gastric emptying on post-operative testing. The advantages of such an approach are numerous including low complication rate, preserving the fundoplication, and avoiding complicated revision surgeries like Nissen fundoplication to gastric bypass conversion. If you suffer from medically refractory gastroparesis, we may able to help you.

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