Laparoscopic placement of the LINX ® system in management of severe reflux after sleeve gastrectomy.

BACKGROUND: Management of severe reflux after sleeve gastrectomy (SG) is often done by conversion to Roux-en-Y gastric bypass (RYGB). The LINX® system could be an alternative treatment.

METHOD: Between 2015 and 2017, 13 patients had LINX® system placed to manage their reflux after SG. Pre-operative evaluation included a barium swallow, endoscopy with pH monitor and esophageal motility.

RESULTS: Ten females and three males with mean age of 49 ± 13 years were evaluated. Their mean weight before placing the LINX® system was 193 ± 45 lbs. and mean BMI of 33 ± 6 kg/m2 . The mean time between SG and placing the LINX® system was 43 ± 19 months. The mean Bravo score was 46 ± 26 (normal 14.7). One patient developed severe dysphagia post-operatively requiring removal of the LINX® after 18 days and one patient was lost to follow up. The mean follow-up in the remaining 11 patients was 26 ± 12 months. The mean GERD-HRQL score dropped significantly from 47/75 ± 17/75 to 12/75 ± 14/75 (p = .0003).

CONCLUSION: The LINX® system may be used as an alternative to RYGB conversion in managing refractory post-SG reflux.