Introduction of the LINX(r) Reflux Management System in a Community Heartburn Center

Meghan Woody, MPH¹, Kaitlin Willems, BS¹, Hannah Vassaur, PAC², Caleb J Wheeless, BS², F. Paul Buckley, III, MD, FACS². ¹Texas A&M Health Science Center, ²Scott & White Healthcare

Introduction: The LINX® Reflux Management System was FDA approved for use in patients with objectively proven gastro-esophageal reflux disease (GERD) and who continue to suffer despite maximum medical therapy. While multiple reports of its successful introduction and use in academic settings exist, we report our experience in a high volume community based reflux center.

Methods & Procedures: The first 50 consecutive cases performed by a single surgeon were reviewed. Descriptive analysis was conducted for demographic data and operative outcomes, including operative time, hospital length of stay, complications, morbidity, and anti-secretory medication use. Comparison was made for GERD health related quality of life (HQRL) scores before and after surgery.

Results: All patients undergoing surgery had objectively confirmed GERD, normal esophageal function, and a hiatal hernia less than 3 centimeters in size. There were no intra-operative complications. There was a single peri-operative complication related to a secondary procedure, and there were no peri-operative complications, readmissions, erosions or reoperations related to LINX®placement. Average operative time was 49 minutes. Mean length of stay was 0.14 days. Over an average follow up of 8 months (range 2 to 17), average GERD HQRL scores improved significantly from 25 to 6 (p-value <0.0001). 90 percent of patients remained off anti-secretory medication. Dysphagia was the most common post-operative complaint and while usually self-limiting, did result in a 10% dilation rate.

Conclusions: The LINX® Reflux Management System is a safe and effective treatment for medically refractory GERD with significant improvement in the quality of life for these difficult to manage patients. Our results mirror other groups reporting their data relative to GERD HQRL scores, elimination of anti-secretory medication use, operative times, and dysphagia rates. The procedure can be safely and successfully introduced into the community setting by high-volume foregut surgeons.