Magnetic Sphincter Augmentation for Gastroesophageal Reflux After Sleeve Gastrectomy: A Systematic Review

Obes Surg. 2024 Nov;34(11):4232-4243. doi: 10.1007/s11695-024-07523-8. Epub 2024 Oct 15.

Abstract

This systematic review aims to evaluate the current evidence regarding safety and efficacy of magnetic sphincter augmentation (MSA) for the treatment of gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG). Conversion to Roux-en-Y gastric bypass (RYGB) carries the risk of surgical and metabolic complications and may be contraindicated in patients with normalized or near-normalized body mass index. The LINX™ procedure aims to restore LES competency and to repair the crura. We included 109 patients (14 studies) undergoing LINX™ implant after LSG. Median follow-up was 18.9 months (range 0.3-63). Both the GERD-HRQL (38 ± 13 vs. 10 ± 11; p = 0.0078) and daily PPI use (97.4% vs. 25.3%; p < 0.0001) were significantly improved. Overall, 31.8% of the patients experienced device-related adverse events, mainly self-limiting. LINX™ explant for esophageal erosion occurred in 0.9% of the patients.

Keywords: Bariatric surgery; Gastroesophageal reflux; LINX procedure; Magnetic sphincter augmentation; Refractory GERD; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Publication types

  • Systematic Review

MeSH terms

  • Esophageal Sphincter, Lower / physiopathology
  • Esophageal Sphincter, Lower / surgery
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Gastroesophageal Reflux* / etiology
  • Gastroesophageal Reflux* / physiopathology
  • Gastroesophageal Reflux* / surgery
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Magnets
  • Obesity, Morbid* / surgery
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery
  • Quality of Life
  • Treatment Outcome