Fred from Houston sent us this comment about LINX: “I read your article and agree with your opinion about LINX. It’s completely wrong to present LINX as option “equal” to Nissen fundoplication, a more established procedure-IT IS NOT. There are too many potential side effects, some of them very serious, and no long-term data to support its claims that suggest it’s in the same category as fundoplication. But the device gets sold to patients, like me, as the “latest and greatest “less invasive, faster recovery, simpler procedure…all BS! I’ve had nothing but problems with LINX surgery since having it in fall 2019. I am scheduled to have it removed on Tuesday. I don’t know what will happen afterwards, if I’ll have to resort to medication again, but I don’t care, I need this thing out of my body. I feel like a fool for having let the surgeon’s pitch on this thing sway me toward LINX (he wore one around his finger like a ring so he could show patients how nifty it was). No disrespect to the medical community, but you are foolish to trust a surgeon’s opinion without doing your own research and getting a second opinion from someone unaffiliated with the first doctor. I believe a lot of surgeons too often act in favor of the net $ gain received from device manufacturers, rather than what’s best for the patient. Even worse, devices don’t go thru the same clinical trial protocols that drugs do, so once it hits the population, side effects start popping up that were either unknown, or “allegedly” of low probability of occurrence. Maybe it’s not the surgeon’s fault for assuming “FDA” approval is enough, but the reality is most of the testing for devices like LINX takes place on an unaware patient population, and device makers know this. Sorry for the rant, but I hate hearing the word “LINX”…too many unpleasant memories”.
Dear Fred,
I completely understand your frustration. I have been critical of LINX surgery ever since it was introduced in Houston. You are right; FDA approval is not enough. LINX surgery is not an effective solution for acid reflux disease and long-term complications are unknown. At Houston Heartburn and Reflux Center, we are seeing an increasing number of disappointed patients, like yourself, who you were sold on the idea that LINX surgery is superior to Nissen fundoplication.
LINX surgery for GERD treatment is not likely to survive the test of time for many reasons. First, there are too many issues associated with placing a foreign body around the lower esophageal junction. This is a dynamic area that is constantly relaxing, contracting and moving. The gastro-esophageal junction cannot be a constrained by any type of band. Any constriction in that area negatively affects esophageal contractions and swallowing. Second, LINX device placement does not address the underlying pathophysiology of acid reflux. Hence, the lower success rate compared to Nissen fundoplication. So far, no studies have been conducted to evaluate LINX vs Nissen fundoplication efficacy and reliability for GERD treatment. Such a trial will precipitate the demise of LINX surgery as a treatment option for GERD. However, in the absence of such a trial it will take several years before LINX surgery is completely abandoned. We have witnessed the same scenario with Lap Band surgery for weight loss and “Those that fail to learn from history are doomed to repeat it”