Long-Awaited Breakthrough to Treat GERD
UW Health surgeons are now offering a recently-approved minimally invasive surgical technique for patients with gastroesophageal reflux disease (GERD).
The LINX®Reflux Management System is a small ring made of interlinked titanium magnetic beads that surgeons implant using laparoscopic techniques. After implantation, the system's magnetic beads bolster the lower esophageal sphincter function and prevent abnormal gastroesophageal reflux.
The magnetic beads relax during swallowing, allowing food to pass through the esophagus into the stomach and maintaining the patient's ability to belch or vomit. This technique does not alter eating and other physiologic functions such as belching.
"The lower esophageal sphincter augmentation system is a long-awaited breakthrough advancement to treat patients with GERD using minimally-invasive techniques," says Guilherme M. Campos, MD, UW Health surgeon and associate professor of surgery at University of Wisconsin School of Medicine and Public Health.
GERD is a chronic disease resulting from a weak lower esophageal sphincter that allows abnormal reflux of gastric fluid into the esophagus, resulting in chronic heartburn, regurgitation, cough and chest pain among others. Current medical therapies reduce patient acid production but do not attend to the source of the problem. This therapy does.
"It is the first system that reproducibly addresses the main pathophysiologic defect in GERD and has documented efficacy in reducing reflux to normal levels using objective testing such as 24-hour pH monitoring," Dr. Campos says.
According to him, most GERD patients who undergo the procedure will no longer need medication to control reflux symptoms.
"The system provides for sphincter augmentation adjusted to each patient's individual characteristics. It reliably controls reflux symptoms with minimal side effects and allows for discontinuing the use of anti-reflux medications such as proton pump inhibitors (PPIs) in the majority of patients," he says.
Approved by the Food and Drug Administration (FDA) in 2012, the system is no temporary panacea.
"It now has efficacy and safety documentation in peer-reviewed publications, and is expected to be a long-lasting solution, as the magnetic beads will continue to work for the patient's lifetime," says Dr. Campos. The LINX® system is recommended for patients with well documented GERD and with an esophageal hiatal hernia less than two centimeters. For patients with GERD and hiatal hernia greater than two centimeters, the standard surgical treatment is still a laparoscopic hiatal hernia repair and a Nissen fundoplication.
Highlighted findings of the FDA clinical trial to which Dr. Campos referred include:
- Before implant, all patients required daily PPIs. After implant, eight percent did.
- Before implant, 70 percent of patients endured reflux that affected their sleep daily. After implant, two percent did.
- Before implant, 76 percent of patients had reflux affecting food tolerances. After implant, two percent did.
- Before implant, 55 percent of patients had severe heartburn affecting daily life. After implant, one percent did.
The LINX® system is one of the multiple minimally invasive surgical options offered at UW Health. Please go to uwhealth.org/minimallyinvasive for more information about these services.