Is LINX Surgery Less Invasive than Nissen Fundoplication?

Is LINX Surgery Less Invasive than Nissen Fundoplication?

Henry from Houston sent us this question: “I had a LINX band placed 4 years ago this November.  I have had problems swallowing ever since. I recently had another esophageal study done showing the LINX band is not working, it remains open, and I have high grade reflux again. My pulmonologist believes many of my lung problems are resulting from aspirating food that gets stuck in the esophagus and acid! I have been seen by a doctor at Mayo Clinic who recommends the removal of the device, repair of the esophagus from the damage LINX caused, repair of a hiatal hernia and the partial Nissen fundoplication or gastric bypass! This is all overwhelming.”

Dear Henry,

Unlike Nissen Fundoplication, LINX surgery is not a reliable solution for acid reflux. Furthermore, contrary to popular belief, LINX device placement is more invasive than Nissen fundoplication. Placing a foreign body around the esophagus is associated with a number of complications like erosion, difficulty swallowing, loss of esophageal motility and aspiration pneumonia. These complications could have been avoided by undergoing a properly performed laparoscopic Nissen fundoplication and hiatal hernia repair.

A properly performed Nissen fundoplication and hiatal hernia repair has a very success rate, very low complication rate and very fast recovery. In your case, a partial fundoplication, also called Toupet fundoplication, was offered because LINX damaged your esophageal motility, and you can no longer tolerate the traditional Nissen fundoplication. I prefer a Toupet fundoplication over gastric bypass for management of acid reflux in the setting of poor esophageal motility especially if you are not overweight. In the majority of cases, esophageal motility partially or fully recovers after stopping acid reflux following fundoplication surgery. Recovery time may take up to one year.