John P Kuckelman, DO, Cody J Phillips, Mark O Hardin, Matthew J Martin, MD. Madigan Army Medical Center
OBEJCTIVE: To describe outcomes with Linx magnetic sphincter augmentation (MSA), and compare outcomes based on standard versus expanded criteria.
BACKGROUND: The Linx device has proven safe and effective for appropriate candidates with GERD. Standard indications include GERD with normal motility, BMI <35, no prior foregut surgery, and no or a small (<3cm) hiatal defect. However, many are offering Linx to candidates outside of these criteria.
METHODS: Retrospective review of Linx procedures at a tertiary center over 1-year. Candidates had demonstrated GERD and normal esophageal motility. Patients were categorized as standard indications (SI) or expanded indications (EI) including large hiatal hernia, BMI>35, or prior foregut surgery. Standard demographics and outcomes were analyzed, including pre & postop GERD quality of life (G-QOL) scores.
RESULTS: Twenty-six patients underwent Linx MSA, with 100% technical success. All operations were completed laparoscopically and no patient required conversion or fundoplication. Overall, there was an average 78% improvement in G-QOL scores, with pre and post scores of 42 vs 9 (p<0.01). There were no significant outcome differences between the SI and EI groups (Figure). G-QOL scores improved from 39 to 7 for the SI group and 44 to 11 for the EI group (both p<0.05). All patients (100%) had improved or resolved GERD with 92% off PPI therapy, and no difference in success between SI or EI groups.
CONCLUSIONS: Linx MSA offers a safe and highly effective new option for patient with GERD. This procedure appears equally effective in patients with larger hiatal hernias or other expanded indications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79222
Program Number: MSS04
Presentation Session: Full-Day Military Surgical Symposium – General Surgery Presentations
Presentation Type: MSSPodium