Linx Implant to Cure Reflux

Digestive health
1

What do you guys think of the Linx implant? Has anybody had this surgery?

I found out about it on Youtube, but most videos seemed like advertisement.

Anyhow the Linx implant seemed less radical than the Fundoplication in which they wrap the stomach around and stich it all together.

The Linx surgery seems reversible at least, whereas the Fundoplication surgery is not.

I'm seriously considering the Linx but would like more information on side effects, such as what is life like living with metal/magnets inside your body? 

Would I set off alarms on banks, store, airports?

What if I accidentaly get and MRI done, what kind of damage would that do to my belly?

Can the metal parts of the Linx device glue to each other, perhaps due to tissue forming around them, preventing it from dilating and impeding my swallowing?

If anybody has any info or experience with this device please let know.

2

Maybe the Stretta treatment is better before you try any of them.

3

I have reservations about Linx. I have followed its development for a number of years. But it is sold on half truths.

Firstly Laparoscopic Nissen Fundoplication is reversible if necessary. (I had mine reversed prior to Collis-Nissen revision.)

Secondly you can burp and vomit after LNF. I burped before leaving hospital the day after my operation (the next day).

The operation tio implant Linx is only slightly less invasive than LNF but the patient wouldn't know. You still have 5 puncture wounds and are out during the procedure.

They don't tell you about the drawbacks of Linx since they are tryng to sell it to you.

1. 63% experience swallowing difficulties. You need to have good peristalsis and take swallow a sufficiently dense bolus to push the magnets apart.

2. It doesn't repair a hiatus hernia. They will only implant Linx if there's a small hernia (or none). They can pull the hernia back into place but it can slide back.

3. If needed, a CT scan can only be done at low power: a) because it's a ring of magnets that will be attracted by an extremely powerful one, and b) because induced electric currents in the wire ring can cause serious burning.

4. In follow up, 85% reported not needing daily PPIs - compared to 95% who had LNF.

5. Long term data is not yet available. (Their claimed long term data is only up to 10 years. LNF has been performed for over 20 years.)

6. We don't know whether the device may migrate or whether cellular overgrowth may reduce the effcacy of the magnetc closure. (Toraz medical, the manufacturers, confided in me 7 years ago they were worried about possible migration which is why they don't recommend it for Barrett's atients or anyone receiving regular endoscopies.)

7. Will the moving magnets cause erosion to the adventia (outer wall of the oesophagus)? 1n the 1970's there was a device ("Angelchik" ) that was effectively like putting a rubber band around the oesophagus. Many were flocking to have the implant. However, 20 years down the line the stampede was to have it removed as it had started causing erosion problems.

8. It costs at least twice as much as LNF. Although it can be implanted in UK under NHS, it's unlikely as LNF is till the gold standard and cheaper. In US many insurance companies won't pay for it deeming it experimental still.

Read about Linx and Angelchik and a host of other reflux reduction techniques in the section of the www DownWithAcid org uk book entitled "Reflux reduction Techniques."

4

Looks interesting, I may try that first, the least invasive the better

5

From the Down with Acid book: 

The Stretta procedure uses radio frequency energy bursts to tighten the lower oesophageal sphincter to help it function correctly.

The manufacturers state, "We do not position Stretta as competitive treatment with surgery – but instead a less invasive bridge that allows some patients for whom medications are not completely effective to avoid surgery and its potential complications, or if someone has had surgery allows them an option other than additional surgery."

A 10 year follow-up report of patients who had received Stretta therapy published in Surgical Endoscopy February 2014 showed  "72 % of patients normalizing GERD symptom scores, 41 % of patients able to remain off regular medication for GERD, 64 % of patients able to reduce medication use by 50 % or greater."

Compared to other techniques, although Stretta sounds easy, it's not very effective. Why pay for that when you can have a fundoplication?

6

Is not about how much you paid, but 41% and 64% sounds pretty good to me for something that is least invasive.  How many people who had the fundoplication didn't have to take a followup procedure within 10 years?

7

Even taking PPI's long term can do you more harm than this and what are the numbers for PPI's? Less than 41%?

8

Only 2 out 5 manged to stop using PPIs after having Stretta. My gastroenterolgist friends call that a fail.

From the Down With Acid book:

A study published in Surgical Endoscopy in 2014 reviewed the durability of Laparoscopic Fundoplication over 20 years and concluded, "Long-term results from the early experience with LF are excellent with 94 % of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up. However, 18 % required surgical revision surgery to maintain their results. There is a relatively high rate of daily dysphagia but 90 % of patients are happy to have had LF."

9

I don't get the point you're making. PPIs aren't harmful. Go to the www BarrettsWessex org uk website ad find "PPI dangers" under the Treatment / Drugs tab.

This month's Clinical Gastroenterology and Hepatology contains this paper: "Study Compares Surgery to Long-Term Drug Tx for Chronic GERD" 

"Esophageal acid reflux was reduced greatly by LARS [Laparoscopic Anti reflux Surgery] or esomeprazole therapy," the authors write. "However, patients receiving LARS had significantly greater reductions in 24-hour esophageal acid exposure after six months and five years."

10

Sounds good and for sure is the best option when it comes to results, but what if it fails or cause more damage which one is safer?  Now, based on what you wrote is 64% vs 94%, so the difference is not that much. 

11

That is an ebook Barretts, I got my information from an official federal site giving us the patients a warning about PPI's.  Now, we do not have to go that far, which medication OTC tells you not to take for more than 14 days?  And then you go to a Doctor and without testing they give you this drug for months?

12

94% is nearly 50% better than 64% but the figures were for different things.

94% of those receiving LNF did not need PPIs after 20 years.

64% of those having Stretta managed with less than half their previous medication.

13

"94 % of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up" ;-)

14

Not just ny book but a book that is also available as an e-book but not in the same league as those produced by snake-oil charlatans.

"a superb compendium of knowledge - thorough, comprehensive, approachable yet scientifically literate... the definitive guide to the subject."

And check out the pages of references at the back. If you find anything that is not factually accurate let me know.

And the FDA warnings about PPIs were due to misuse of the drugs in USA. If purchased OTC, they should not be used for more than 14 days unless under supervision of a doctor.

In UK, they were not available OTC until very recently - despite our complaints. We now have to wait to see whether the induced hypochlorhydria from misuse arises here as well. (See the PPI dangers page on Barrett's wessex website.)

15

Yes, the book is very good and I believe everyone here including myself appreciate all the help you have given us.  Myself I don't really care to much for PPI's and H2 Blockers because the have done nothing for me so not taking them is very easy for me. Now, In the time I took them they did not give me any side effects as well. Now, I'm starting to wonder if I actually have any reflux problem besides having a mild condition because not even Carafate has done anything for me.  Had my esophageal manometry done yesterday so maybe that will direct me in the right direction. Still, if I had the option to select right now I would take the Stretta Therapy first but will have no problem taking the fundoplication if that did not help me.

16

Barretts has an axe to grind with his/her writing on Down With Acid and is evidently more concerned about Barretts Syndrome than the lesser problems that most here suffer from. With proper early treatment will many progess to to Barretts Syndrome ?

He/she evidently is against many conventional treatments and more knowledgeable than many in the medical profession. 

17

I agree, and I can see his point of view because he had a pretty severe case and he is now cured. An incredible success story. ;-)   But like you said, many of us have lesser problems which can be resolved without going to the extreme by taking a more conventional treatment.  I myself don't even know if any of this will help me at all and I had done just about 75% of all the testing they can do.  I believe GI's are clueless in most cases and they just use us as Ginea Pigs and financial support because they don't know any better.  ;-(

18

Hi,

I had a fundopliaction 10 years ago and it has failed in a way that leaves my condition  worse than it was before the operation. Surgeons seem very reluctant to undertake a "redo". I would never have this procedure if there was any alternative and so I would expore every other avenue and use a fundoplication as a last resort.