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LINX® reflux surgery

Treatments / Procedures / LINX® reflux surgery

The LINX® System is designed to reproduce the physiological valve at the bottom of the oesophagus. It is a small, flexible band of interlinked titanium beads with magnetic cores that helps create a barrier to the reflux of acid and bile. The LINX® System is placed around the oesophagus just above the stomach during a laparoscopic or “keyhole” surgery, which is generally completed in less than an hour.

Linx quarter

When the LINX® System is in place, swallowing forces temporarily break the magnetic bond to allow food and drink to pass normally through the Lower Oesophageal Sphincter (LOS). The magnets then close the LOS immediately after swallowing to restore the body’s natural barrier to the reflux of acid and bile.

There have now been well over 15,000 operations worldwide and the results are very encouraging. LINX has been shown to work very effectively to stop reflux symptoms. As a minimally invasive procedure, it is considered safe and has fewer associated side effects than fundoplication operations (fundoplication has a 5-10% revision rate within 5 years due to technical failure or recurrent symptoms). Patients recover rapidly from the operation.

Does it work?

There have now been several research studies published which have looked at the safety and efficacy of LINX® up to five years following surgery. These have consistently shown the following:

  • Significant and maintained reductions in reflux symptoms
  • Normalisation of acid exposure in the oesophagus
  • Significant improvements in quality of life
  • Most patients remaining off medication
  • Significantly fewer side effects than those caused by fundoplication operations
  • A low complication rate

The LINX implant results in pH normalisation, an improved quality of life, and complete cessation of regular PPI (Proton Pump Inhibitor) in the majority of patients. The ability to belch and vomit is maintained after the implantation of LINX, and de novo moderate to severe gas-bloat is uncommon. When compared with laparoscopic fundoplication, rates of success in alleviating GORD (Gastro Oesophageal Reflux Disease) symptoms and dysphagia are similar following the LINX procedure. Bloating side effects may also be lower. Longer-term follow up data demonstrates that the LINX management System is effective in the management of GORD (Gastro Oesophageal Reflux Disease).

What are the side effects?

Side effects following the LINX® System procedure are minimal and generally resolve over time.

  • Mild dysphagia (difficulty swallowing) occurs in less than half of patients after the procedure and is generally resolved within 90 days without treatment.
  • Unlike other surgical treatments, the LINX® System does not have the side effect of restricting belching and vomiting.

Does the effect last?

Studies have indicated that the LINX may be more durable than the fundoplication but definitive evidence is currently lacking.

What about recovery following surgery?

Surgery to insert the LINX® system is less invasive than fundoplication. The majority of patients can leave hospital on the same day as surgery if they wish to.

The LINX® System starts to work as soon as it is in place. Patients should be able to resume a normal diet within a few hours of surgery and can usually return to normal activities in less than a week.

What are the possible complications?

While all surgery carries the risk of complications the LINX® System procedure does not involve any changes to the anatomy of the stomach and is fully and easily removable. The first LINX® Reflux Management System procedure took place in 2007. In the time that the procedure has been performed there have been no reports of the device migrating from the site of implantation.

Complications are rare, they include;

  • Hernia
  • Bleeding
  • Visceral injury

The LINX removal rate is 2-3% globally but less than 1% in RefluxUK patients, removal is straightforward if necessary with no change to the patients anatomy. LINX removal is usually because of persistent dysphagia or lack of effect

The most serious complication to date has been erosion (where the LINX device intrudes into the oesophagus) but this happens in less than one in seven hundred and fifty cases and removal is again straightforward if required.

LINX FAQS

  • What is LINX?

    The LINX® System is a medical device indicated for patients diagnosed with pathologic Gastro-oesophageal Reflux Disease (GORD) defined by abnormal pH testing and who continue to have chronic GORD (Gastro-oesophageal Reflux Disease) symptoms despite maximum medical therapy. LINX® is placed around the Lower Oesophageal Sphincter (LOS) using a simple technique called laparoscopy (keyhole surgery).

  • Who is LINX for?

    The LINX® System is suitable for chronic GORD (Gastro-oesophageal Reflux Disease) sufferers who do not respond fully to medication.

  • Will I be cured?

    The LINX® Reflux Management System is designed to work with your lower oesophageal sphincter to reduce the symptoms of GORD(Gastro-oesophageal Reflux Disease). However, there is a chance you may still have some symptoms of reflux, such as heartburn, after the implant. Even normal, healthy people can suffer from heartburn or reflux at times. Your doctor or nurse can advise you on how to avoid this, such as eating smaller meals.

  • When can I start eating normally again?

    Try to return to a normal diet as quickly as you feel able to do so. This helps your body adapt to the LINX® Reflux Management System.

  • When can I return to normal physical activities?

    Generally, patients can return to non-strenuous activity within a couple of days. However, as with any surgical procedure, you should consult your doctor about what activities you can do and how soon you can do them after the insertion of the LINX® System.

  • Is there a risk of my body rejecting the LINX® Reflux Management System?

    The LINX® System is designed to minimize the risk of rejection. All areas of the device that contact the body are made of materials that are used frequently in medical devices and have proven to be very stable. However, if you have a medical history that suggests you may be at increased risk of your body rejecting a medical device, it is important that you tell your doctor about this before receiving a LINX® Reflux Management System.

  • Will the magnets wear out?

    The LINX® Reflux Management System uses permanent magnets and therefore will not wear out.

  • Can I go through airport security?

    The LINX® Reflux Management System should not affect airport security. However, all patients will be provided with an implant card to have available in case an issue arises.

  • Can I have an MRI test after receiving the LINX® Reflux Management System?

    If you are told you need an MRI procedure, please contact your LINX® physician. It is important to know which LINX® device you have. The LX models of LINX® are considered MR Conditional in a magnetic resonance imaging (MRI) system up to 0.7 Tesla. The LXM models of LINX® are considered MR Conditional in a MRI system up to 1.5 Tesla. Scanning under different conditions may interfere with the magnetic strength and function of the device. LINX® implants PRIOR to September 10, 2015 have the LX model. If your LINX® implant was AFTER September 10, 2015, contact your LINX® physician.

  • Will I need a follow-up endoscopy?

    An endoscopy is not required after the LINX® procedure.

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