The LINX® Reflux Management System is an FDA-approved device that may be recommended for patients experiencing symptoms of gastroesophageal reflux disease (GERD).
Surgical treatment of GERD should be considered when patients’ symptoms are not controlled with lifestyle modification and medications. Patients who do not want to take medications indefinitely may also want to consider surgical options.
Frequently Asked Questions About LINX®
How does LINX® work?
During the procedure, a small, flexible band of magnetic titanium beads is implanted around the esophagus in a minimally invasive procedure. When in place, the band supports a weak lower esophageal sphincter (LES), the muscle that opens and closes to allow food to enter and stay in the stomach. The magnetic attraction between the beads is strong enough to resist the gastric pressures that result in reflux, but is weak enough to allow for swallowing, belching or vomiting.
Patients are placed under general anesthesia during the procedure, which is completed in approximately an hour. Every case is different, so there is some variability in the time it takes to perform the procedure. Once implanted, the device will begin working immediately.
What preparation is required before LINX®?
Before considering a LINX® procedure, patients must undergo an evaluation that includes upper gastrointestinal (GI) endoscopy and physiologic testing such as esophageal motility (swallowing) testing. Patients with weak esophageal peristalsis or hiatal hernias larger than 2 cm are not candidates for the LINX® procedure. No preparation is required for the procedure itself.
What is the recovery time and follow-up?
After the procedure, patients stay in the hospital overnight to ensure there are no complications from the surgery or anesthesia. Patients should be able to eat soft foods within 48 hours of surgery.
Patients may resume routine daily activities within a few days of surgery when pain medicine is no longer required. Activities such as sit-ups or weight lifting, which require use of the abdominal muscles, should be put off for three to six weeks.
Patients generally call in seven days post-op to speak with a physician and have a follow-up appointment two weeks post-op with their physician to monitor recovery progress.
Who is eligible for LINX®?
Not all patients are candidates for the procedure. A full evaluation is needed to determine if a patient is eligible.
Ideal candidates include patients who:
- Are 21 years or older
- Have had an incomplete response to proton pump inhibitors (PPIs) in treating GERD
- Respond well to medications but do not want to continue taking medications indefinitely
Patients who have experienced any of the following may not be eligible for the procedure:
- Difficulty swallowing
- Hiatal hernia larger than 2 cm
- Body mass index (BMI) greater than 35
- Barrett’s esophagius with dysplasia
- Prior anti-reflux surgery
- Have a pacemaker in place
How safe is the procedure?
A carefully performed clinical trial showed the LINX® procedure’s effectiveness. Patients experienced no operative complications and were discharged within 48 hours. Within the first year, 77% indicated that they had achieved normal pH levels and 90% of patients had stopped using PPIs. At four years follow up, the study has shown the procedure to be safe and effective.
Read more on the study
Between 1/3 and 1/2 of patients have temporary difficulty swallowing solid food in the first month post-op. If this problem persists, it may require endoscopy with stretching of the esophagus to hasten this phase of recovery.
All surgical procedures have risks, such as the risks associated with anesthesia, risk of bleeding and risk of infection. These risks are small. The most common side effects of LINX® are difficulty swallowing and post-operative pain.
Why Mass General?
Mass General was the first hospital in New England to offer the LINX® Reflux Management System, and we are consistently ranked among the best hospitals in the country by U.S. News & World Report. Our surgeons, among the most experienced in the region, are accustomed to seeing both local and international patients with a variety of medical conditions.