Page 12 - World Journal of Laparoscopic Surgery

WJOLS

Bipin T Prasad 10.5005/jp-journals-10033-1303
REVIEW ARTICLE

LINX Magnetic Esophageal Sphincter Augmentation

vs Laparoscopic Nissen Fundoplication for
Gastroesophageal Reflux Disease

Bipin T Prasad

ABSTRACT result in significant postoperative morbidities, which are
The LINX magnetic sphincter augmentation system is a sur- dysphagia and bloating mainly. 8
gical technique with short-term evidence demonstrating the The LINX magnetic sphincter augmentation (MSA) is
efficacy in the treatment of medically refractory or chronic a device in the form of a ring of magnetic beads, laparo-
gastroesophageal reflux disease (GERD). Currently, the scopically placed at the distal esophagus to increase the
Nissen fundoplication is the gold standard surgical treatment LES tone.
for GERD.
This document reviews the advanced treatment of
Keywords: Gastroesophageal reflux disease, Magnetic sphinc- GERD, applicable to laparoscopic surgery and also a
ter augmentation, Nissen fundoplication. comparison study between MSA and LNF.
How to cite this article: Prasad BT. LINX Magnetic Esopha-
geal Sphincter Augmentation vs Laparoscopic Nissen Fundo- AIM
plication for Gastroesophageal Reflux Disease. World J Lap
Surg 2017;10(2):54-56. The aim of this study was to compare the effectiveness
of the two surgical modalities, namely MSA and LNF,
Source of support: Nil
on a larger scale.
Conflict of interest: None
MATERIALS AND METHODS
INTRODUCTION
The inclusion criteria are: (1) Studies that included one or
Gastroesophageal reflux disease (GERD) affects approxi- more primary outcome of interest, (2) a direct comparison
mately 25% of the population and its prevalence is study between MSA and LNF.
1
increasing. First-line treatment of GERD consists of
lifestyle modification and medical therapy with proton Outcomes of Interest
pump inhibitors (PPIs). Although PPIs are efficacious in • Ability to belch
the majority of GERD patients, nearly 30% of the indi- • Ability to emesis
viduals on optimized PPI therapy have persistence of • Operative time
2-4
symptoms. The main reason for PPI resistance is due • Discontinuation of PPI
to nonacid reflux of gastric contents through an incom- • Endoscopic dilation
5
petent lower esophageal sphincter (LES). Other causes • Dysphagia and bloating features.
for PPI resistance or failure can be due to esophageal Morbidities associated with both the surgical modali-
dysmotility disorder, paraesophageal hernia, and erosive ties are also taken into account.
esophagitis. 6,7
Laparoscopic Nissen fundoplication (LNF) is the Statistical Analysis
gold standard treatment for medically refractory GERD.
Although the LNF provides excellent resolution of GERD, With regard to the above-mentioned outcomes of interest,
MSA and LNF were compared.
the extensive operative procedural manipulation may
DISCUSSION

Assistant Professor It was found that MSA has similar efficacy to LNF, which
Department of General Surgery, Dr. Somervell Memorial CSI is the gold standard treatment. In preserving the ability
Medical College & Hospital, Thiruvananthapuram, Kerala, India to emesis and belch and also less features of dysphagia
Corresponding Author: Bipin T Prasad, Assistant Professor and bloating (clinical basis), MSA holds a significant
Department of General Surgery, Dr. Somervell Memorial CSI advantage over LNF.
Medical College & Hospital, Thiruvananthapuram, Kerala, India Magnetic sphincter augmentation functions as a
Phone: +919895901732, e-mail: bipin.thomas@rocketmail.com
purely mechanical treatment for GERD, as it prevents
54