Tim from Houston sent us this question:
“I’m wondering if (1) Dr Darido has first-hand experience with implantation of the LINX™ device to treat GERD and (2), if so, would its potential removal and follow-up application of Nissen Fundoplication subsequently prevent return of GERD?
It seems there are acid reflux patients experiencing delayed pains following LINX™ surgery and opting to have their device removed. Not sure of the location, duration, severity of their pains and nobody seems to know what the actual cause of the pain is, or if indeed it’s associated with this device. Best I can tell, my concurrent pains occur over the center of my chest where the device sits, near my gall bladder and appendix, in my right-side neck and lower jaw, behind my right eye and along my right-side temple. Suspect it’s all associated with a nerve pathway of some sort for it to be that extensive. I’m wondering what my options are, if Dr Darido is knowledgeable about this issue, and if having a balloon stretch might rid or alleviate these pains.”
Dear Tim,
At Houston Heartburn and Reflux Center, competent acid reflux specialists and Nissen fundoplication surgery experts have hard time recommending LINX™ surgery to their patients. Nissen fundoplication surgery, when properly performed, is safe, durable and very effective cure for acid reflux. For this reason, we see no indication for LINX™ surgery. Consequently, we don’t have any first-hand experience with implantation of the LINX™ device to treat GERD. LINX™ device removal may be complicated due to scar tissue formation and erosion of LINX™ device into esophageal musculature. Once removed, conversion to Nissen fundoplication will most likely stop all acid reflux related symptoms.
Substernal and epigastric pain of unknown etiology, following LINX™ device placement, has been described. Fortunately, it is not common. Pain typically does not radiate beyond esophagus anatomical location and is not associated with any other symptom. Our experience with LINX™ device removal for this particular presentation is limited. It is crucial to rule out prior to LINX™ device removal any other potential cause of substernal pain.