Linx Procedure for Reflux
The LINX® System strengthens the weak Lower Esophageal Sphincter (LES) to help prevent reflux
The LINX® System is a small, flexible band of magnets enclosed in titanium beads. The beads are connected by titanium wires. The magnetic attraction between the beads helps keep the weak LES closed to prevent reflux (see Figure 1). Swallowing forces temporarily break the magnetic bond, allowing food and liquid to pass into the stomach (see Figure 2). Magnetic attraction closes the LES after swallowing, to reinforce the body’s natural barrier to reflux.
How is the LINX® System implanted?
The LINX® System is placed around the esophagus just above the stomach using a common, minimally invasive, surgical technique called laparoscopy. Patients are placed under general anesthesia during the procedure, which is generally completed in less than one hour. Once implanted, the device will begin working immediately.
TIF/Esohpyx Procedure for Reflux
TIF is an acronym for Transoral Incisionless Fundoplication and the procedure is designed to surgically reconstruct a defective gastroesophageal valve to restore the reflux barrier.
Performed entirely through the mouth without the need for external incisions through the skin, the TIF procedure offers patients a method of anatomically correcting their weak sphincter. Because no incisions are required, recovery is faster than the laparoscopic fundoplication. The EsophyX/TIF procedure reinforces the gastroesophageal junction by folding the upper portion of the stomach around the lower portion of the esophagus and securing it in place by special fasteners. We started performing this procedure in 2009 and have performed over 100 procedure to date, making us one of the most experienced centers in the United States. The TIF procedure improves reflux symptoms more effectively than anti-acid medication and enables the majority of patients to stop taking antacid medications all together. The TIF procedure is generally limited to patients with no or very small hiatal hernias (<3cm) and a body mass index (BMI) of <30.
Nissen Fundoplication Procedure for Reflux
Nissen surgery helps prevent reflux by supporting the lower esophagus with the upper stomach.
The fundoplication is a laparoscopic surgery done through 5 small incisions that consists of folding (plicating) the stomach around the lower esophagus, thereby recreating a lower esophageal acid barrier which can restore the normal function of the gastroesophageal junction. When this procedure is performed, if a patient has a hiatal hernia, it is repaired at the same time.
Most patients stay overnight in the hospital and can return to work in 2 weeks after this laparoscopic procedure.
Medication for Reflux
Medication can be beneficial in treating the symptoms, but not the cause, of acid reflux
Treating acid reflux with medication can be effective for those suffering from various levels of acid reflux; however, many medications require long term use to prevent a relapse in symptoms. Typical treatment methods include the use of antacids to neutralize stomach acid and medications that reduce acid production for short periods of time (H2 blockers) or long periods of time like proton pump inhibitors (PPI's).
Medications that reduce or block stomach acid provide longer-lasting relief but in some patients require increasing doses for the same level of relief. Additionally, like many strong medications, PPIs have been shown to have side effects. An increasing number of studies point to these side effects such as osteoporosis, vitamin B12 deficiency, PPI-associated pneumonia, colitis, dementia and chronic kidney disease. Patients should know there are options. At TBRC we believe in providing patients the information so that they can weight the pros and cons of each treatment modality and pick what is best for them.