The effectiveness of the magnetic ring (LINX^®) Device in managing reflux after sleeve gastrectomy; long term results: a seven-years’ experience

Abstract

Aim: The magnetic ring (LINX®) system was approved by the FDA in 2012 as a device to augment the lower esophageal sphincter pressure to manage reflux in the general population. It was introduced into the bariatric population in 2014 as an alternative to Roux-en-Y gastric bypass (RYGB) in managing reflux after sleeve gastrectomy (SG).

Materials: Between January 2015 and December 2021, Seventeen patients had the Magnetic Ring (MR) device placement to manage their reflux after SG.

Methods: The mean age was 54 ± 12 years. Their mean body mass index (BMI) was 31 ± 6 kg/m². The mean time between the SG and MR device placement was 41 ± 19 months. The mean DeMeester score was 48 ± 26 (normal < 14.72).

Results: All seventeen patients underwent a successful laparoscopic placement of the MR device. Two patients had early post-operative dysphagia requiring removal of the device and one patient was lost to follow-up. The mean follow up of the remaining fourteen patients was 65 ± 31 months. Recurrent reflux occurred in 11 (79%). In three of these eleven (27%) patients the recurrent reflux was due to a broken device. None of these patients were interested in conversion to RYGB.

Conclusion: The MR device is a valuable tool in treating reflux after SG in spite of its potential risk of recurrence. Our results can be interpreted as being dissatisfying if complete resolution is the goal. Larger studies, with more than 3 year follow up, are needed before a final decision is made on its value in the bariatric population.

Keywords

Reflux / sleeve gastrectomy / Roux-en-Y gastric bypass / LINX® system / magnetic ring device / augmentation of lower esophageal sphincter

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