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Magnetic sphincter augmentation

Robert A Ganz
A magnetic implant for the treatment of GERD was FDA-approved in 2012 and has been extensively evaluated. The device is a ring of magnets, that are placed around the gastroesophageal junction, augmenting the native lower esophageal sphincter and preventing reflux yet preserving LES physiologic function and allowing belching and vomiting. Magnetic force is advantageous, being permanent and precise, and forces between magnets decrease with esophageal displacement. Multiple patient cohorts have been studied using the magnetic device, and trials establish consistent, long-term improvement in pH data, GERD symptom scores and PPI use...
December 23, 2016: Clinical Gastroenterology and Hepatology
Daniel Skubleny, Noah J Switzer, Jerry Dang, Richdeep S Gill, Xinzhe Shi, Christopher de Gara, Daniel W Birch, Clarence Wong, Matthew M Hutter, Shahzeer Karmali
BACKGROUND: The LINX(®) magnetic sphincter augmentation system (MSA) is a surgical technique with short-term evidence demonstrating efficacy in the treatment of medically refractory or chronic gastroesophageal reflux disease (GERD). Currently, the Nissen fundoplication is the gold-standard surgical treatment for GERD. We are the first to systematically review the literature and perform a meta-analysis comparing MSA to the Nissen fundoplication. METHODS: A comprehensive search of electronic databases (e...
December 15, 2016: Surgical Endoscopy
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
Zaheer Nabi, D Nageshwar Reddy
Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the core of GERD management. However, a substantial number of patients do not respond well to PPIs. The next option is anti-reflux surgery, which is efficacious, but it has its own limitations, such as gas bloating, inability to belch or vomit, and dysphagia...
September 2016: Clinical Endoscopy
Kais A Rona, Jessica Reynolds, Katrin Schwameis, Joerg Zehetner, Kamran Samakar, Paul Oh, David Vong, Kulmeet Sandhu, Namir Katkhouda, Nikolai Bildzukewicz, John C Lipham
BACKGROUND: Magnetic sphincter augmentation (MSA) has demonstrated long-term safety and efficacy in the treatment of patients with gastroesophageal reflux (GERD), but its efficacy in patients with large hiatal hernias has yet to be proven. The aim of our study was to assess outcomes of MSA in patients with hiatal hernias ≥3 cm. METHODS: We retrospectively reviewed all patients who underwent MSA at our institutions over a 6-year period. Information obtained consisted of patient demographics, symptoms of GERD, preoperative GERD Health-Related Quality-of-Life (HRQL) scores, perioperative details, and implantation of the MSA device...
August 23, 2016: Surgical Endoscopy
Mia Kim, Paul-Antoine Lehur
INTRODUCTION: Magnetic anal sphincter augmentation improves function and quality of life of patients with severe fecal incontinence substantially. Measuring the anal circumference exactly with a sizing tool represents a crucial step of the procedure because it determines the correct size and success of the definite implant. OBJECTIVE: This study aims to illustrate the consequent development of 3 different sizing models and the use of the recent sizing tool. TECHNIQUE: After dissection of a tunnel around the anal canal through a ventral perineal incision, the sizing tool is inserted by using a specially designed introducer to measure the circumference for the appropriate size of implant...
September 2016: Diseases of the Colon and Rectum
Emanuele Asti, Gianluca Bonitta, Andrea Lovece, Veronica Lazzari, Luigi Bonavina
Only a minority of patients with gastro-esophageal reflux disease (GERD) are offered a surgical option. This is mostly due to the fear of potential side effects, the variable success rate, and the extreme alteration of gastric anatomy with the current gold standard, the laparoscopic Nissen fundoplication. It has been reported that laparoscopic Toupet fundoplication (LTF) and laparoscopic sphincter augmentation using a magnetic device (LINX) can treat reflux more physiologically and with a lower incidence of side-effects and reoperation rate...
July 2016: Medicine (Baltimore)
Heather F Warren, Brian E Louie, Alexander S Farivar, Candice Wilshire, Ralph W Aye
OBJECTIVE: To evaluate the manometric changes, function, and impact of magnetic sphincter augmentation (MSA) on the lower esophageal sphincter (LES). BACKGROUND: Implantation of a MSA around the gastroesophageal junction has been shown to be a safe and effective therapy for gastroesophageal reflux disease, but its effect on the LES has not been elucidated. METHODS: Retrospective case control study (n = 121) evaluating manometric changes after MSA...
July 26, 2016: Annals of Surgery
Christopher Crawford, Kyle Gibbens, Daniel Lomelin, Crystal Krause, Anton Simorov, Dmitry Oleynikov
BACKGROUND: Obesity is an epidemic in the USA that continues to grow, becoming a leading cause of premature avoidable death. Bariatric surgery has become an effective solution for obesity and its comorbidities, and one of the most commonly utilized procedures, the sleeve gastrectomy, can lead to an increase in gastroesophageal reflux following the operation. While these data are controversial, sometimes operative intervention can be necessary to provide durable relief for this problem...
July 20, 2016: Surgical Endoscopy
Emanuele Asti, Stefano Siboni, Veronica Lazzari, Gianluca Bonitta, Andrea Sironi, Luigi Bonavina
OBJECTIVE: The aim of this study was to identify patients' characteristics that may predict failure and removal of the Linx sphincter augmentation device, and to report the results of 1-stage laparoscopic removal and fundoplication. BACKGROUND: The Linx device is a long-term magnetic implant that was developed as a less disruptive and more reproducible surgical option for patients with early-stage gastroesophageal reflux disease (GERD). Removal of the device has been shown to be feasible, but no long-term results of this procedure have been reported yet...
May 9, 2016: Annals of Surgery
Paul Antoine Lehur, Vincent Wyart, Valery Pierre Riche
No abstract text is available yet for this article.
August 2016: International Journal of Colorectal Disease
Hongke Zhang, Dinghui Dong, Zhengwen Liu, Shuixiang He, Liangshuo Hu, Yi Lv
BACKGROUND: Gastroesophageal reflux disease (GERD) is a prevalent disease which severely impacts the quality of life of the patients. The surgical options are limited to such patients who are not satisfied with medical therapies. Magnetic sphincter augmentation (MSA) is a new antireflux surgical technique for treating GERD, which could physiologically reinforce the lower esophageal sphincter by magnetic force. Many clinical and animal studies have focused on this new therapy. The purpose of this work was to review the feasibility, efficacy and safety of MSA as a new treatment for GERD...
September 2016: Surgical Endoscopy
Joel R Brockmeyer, Erin E Connolly, Richard J Wittchow, Shanu N Kothari
Gastric polyps occur from a variety of sources and are found commonly on upper endoscopy. We present the case of a 49-year-old female who presented for evaluation for antireflux surgery with a history of fundic gland polyposis who required twice-daily proton pump inhibitors (PPIs) for control of her gastric reflux. After verifying that she met criteria for surgery, she underwent an uncomplicated laparoscopic magnetic sphincter augmentation placement. With the cessation of PPIs following surgery, the fundic gland polyposis resolved...
2015: Case Reports in Gastrointestinal Medicine
Jamil L Stetler, Sujata Gill, Ankit Patel, S Scott Davis, Edward Lin
BACKGROUND: Nissen fundoplication is the current gold standard for surgical management of gastroesophageal reflux disease; however, a magnetic antireflux device is now an alternative surgical procedure. The early literature shows good reflux control with minimal complications, and therefore placement of these devices is growing in popularity. As more of these devices are placed, there will be cases in which they will need to be removed. A laparoscopic method for removing the device is presented here...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Heather F Warren, Jessica L Reynolds, John C Lipham, Joerg Zehetner, Nikolai A Bildzukewicz, Paul A Taiganides, Jody Mickley, Ralph W Aye, Alexander S Farivar, Brian E Louie
BACKGROUND: Magnetic sphincter augmentation (MSA) has emerged as an alternative surgical treatment of gastroesophageal reflux disease (GERD). The safety and efficacy of MSA has been previously demonstrated, although adequate comparison to Nissen fundoplication (NF) is lacking, and required to validate the role of MSA in GERD management. METHODS: A multi-institutional retrospective cohort study of patients with GERD undergoing either MSA or NF. Comparisons were made at 1 year for the overall group and for a propensity-matched group...
August 2016: Surgical Endoscopy
Jessica L Reynolds, Joerg Zehetner, Angela Nieh, Nikolai Bildzukewicz, Kulmeet Sandhu, Namir Katkhouda, John C Lipham
BACKGROUND: Magnetic sphincter augmentation (MSA) is approved for uncomplicated GERD. Multiple studies have shown MSA to compare favorably to laparoscopic Nissen fundoplication (LNF) in terms of symptom control with results out to 5 years. The MSA device itself, however, is an added cost to an anti-reflux surgery, and direct cost comparison studies have not been done between MSA and LNF. The aim of the study was to compare charges, complications, and outcome of MSA versus LNF at 1 year...
August 2016: Surgical Endoscopy
Greta Saino, Luigi Bonavina, John C Lipham, Daniel Dunn, Robert A Ganz
BACKGROUND: As previously reported, the magnetic sphincter augmentation device (MSAD) preserves gastric anatomy and results in less severe side effects than traditional antireflux surgery. The final 5-year results of a pilot study are reported here. PATIENTS AND METHODS: A prospective, multicenter study evaluated safety and efficacy of the MSAD for 5 years. Prior to MSAD placement, patients had abnormal esophageal acid and symptoms poorly controlled by proton pump inhibitors (PPIs)...
October 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Kenneth Desart, Georgios Rossidis, Michael Michel, Tamara Lux, Kfir Ben-David
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. OBJECTIVES: The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy...
October 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jessica L Reynolds, Joerg Zehetner, Phil Wu, Shawn Shah, Nikolai Bildzukewicz, John C Lipham
BACKGROUND: The efficacy and safety of magnetic sphincter augmentation (MSA) with the LINX device (Torax Medical) has been reported in several short-and long-term studies, rivaling historic results of laparoscopic Nissen fundoplication (LNF), but with fewer side effects. However, there have been no studies comparing patients with similar disease to validate these results. STUDY DESIGN: We conducted a retrospective analysis of 1-year outcomes of patients undergoing MSA and LNF from June 2010 to June 2013...
July 2015: Journal of the American College of Surgeons
Rudolf J Stadlhuber, Attila Dubecz, Alexander Meining, Hubert J Stein
Recently an alternative treatment option utilizing a laparoscopically placed magnetic sphincter device has been introduced for gastroesophageal reflux disease patients who are hesitant to undergo Nissen-fundoplication. Based on previous experience with similar devices, concerns have been raised about migration, and in case of a subsequently developing esophageal cancer, technical challenges during the endoscopic or surgical treatment caused by the foreign body reaction around the abdominal esophagus. In this article, we report of the first case of esophagectomy for cancer in a patient with a previously implanted magnetic sphincter augmentation device...
June 2015: Annals of Thoracic Surgery
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