LINX Device for Heartburn Treatment in Houston
“Objective Evidence of Reflux Control After Magnetic Sphincter Augmentation: One Year Results From a Post Approval Study”, is a new multicenter, prospective, study recently published in the Annals of Surgery journal. 200 patients with objective evidence of acid reflux were treated with LINX device surgery between 2013 and 2015. At one year after surgery, only 74% of patients had normal esophageal acid exposure. LINX device removal rate at one year was 1%. One LINX device erosion was reported. The authors conclude that LINX device is both safe and effective for treatment of GERD.
Our results at Houston Heartburn Center are much better. On one hand we have a 100% patient satisfaction and 0% surgery failure rate. Since 2015, our redo surgery rate is less than one per one thousand hiatal hernia repair and Nissen fundoplication. Since we don’t use LINX device, our erosion and device failure rate are zero. Most importantly, however, is safety and effectiveness of Nissen fundoplication. Our mortality rate is zero and our 30-day complication rate is less than 1%. Nissen fundoplication when properly performed completely eliminates acid reflux. LINX device in this study eliminates acid reflux in only 74% of cases. Nissen fundoplication does not impair esophageal motility. LINX device is a barrier against esophageal contractions and is contraindicated in patients with weak esophageal peristalsis.
The superiority of a properly performed Nissen fundoplication in controlling GERD is closely associated with its mechanism of action. Nissen fundoplication does not simply augment the lower esophageal sphincter as LINX device is assumed to do. Acid reflux is a complex esophago-gastric motility disorder. GERD pathogenesis is not limited to a weak LES. Meticulous hiatal hernia repair restores normal gastro-esophageal junction anatomy and Nissen fundoplication restores a competent reflux barrier without impeding esophageal motility and food emptying from esophagus into stomach. For these reasons, we are hesitant at Houston Heartburn Center to offer LINX device for treatment of stage 3 or stage 4 acid reflux disease.