If you have had a positive diagnosis of gastro-oesophageal reflux disease (GORD) or laryngopharyngeal reflux (LPR), there are a number of treatments available to you. These can include medication and lifestyle modifications and surgery. Surgery is usually only recommended in cases of reflux disease that fail to respond to other treatments.
Here, we look at the LINX Reflux Management System.
What is LINX?
The LINX Reflux Management System (LINX) is a surgical treatment intended for patients diagnosed with gastro-oesophageal reflux disease who continue to have chronic symptoms despite medical therapy.
LINX is a small flexible band of interlinked titanium beads with magnetic cores which is implanted or wrapped the stomach valve called the lower oesophageal sphincter (LOS).
The beads are designed to keep the valve closed to prevent stomach contents refluxing into the oesophagus, while at the same time opening to allow food to go down.
The system is manufactured by Torax Medical, now owned by Ethicon, part of the Johnson & Johnson Medical Devices Companies.
How is it fitted?
The LINX System is placed around the oesophagus just above the stomach through a laparoscopy or keyhole surgery.
Patients are typically placed under general anaesthesia and the abdomen is accessed by four incisions and inflated by gas usually in a procedure that takes less than one hour.
Patients should be able to resume a normal diet within a few hours of surgery and can usually return to normal activities in less than a week.
Watch this video of LINX surgical footage.
What happens when you eat?
The magnets keep the LOS closed to prevent reflux but will temporarily open when you swallow food and drink or when you burp or vomit.
Most patients say they are able to resume a normal diet within days of the surgery.
How much does it cost?
In the UK, availability of LINX on the NHS is currently limited to selected hospitals. The price for private treatment in the UK is typically around £8,000-£9,000 – for example, the Reflux Centre charges £8990. In the US, surgery tends to cost between $12,000 and $20,000.
How effective is it?
There have now been around 40,000 operations worldwide and the device has been shown to help stop reflux symptoms.
The LINX system uses permanent magnets that are designed never to wear out. Patients have reported improvements in heartburn and regurgitation symptoms, many are able to stop taking reflux medication and many are able to resume a normal diet following surgery with minimal side effects.
Five years after treatment, 88 per cent of patients reported that heartburn had been eliminated, while 85 per cent of patients were free from dependence on daily reflux medication. Ninety-nine per cent of patients had eliminated regurgitation at five years.
An investigation, known as the CALIBER Study, compared LINX with double-dose proton pump inhibitors (PPIs) for the management of reflux symptoms with 150 patients at 22 centres.
Data from the trial reveals the LINX device was more effective than proton pump inhibitor therapy for treating regurgitation in patients with GERD. [https://www.peptest.co.uk/linx-effective-reflux-medication/]
How long does it last?
LINX is designed to be a lifelong implant.
Are there any side effects?
Potential complications associated with the LINX Reflux Management System include achalasia (lower part of oesophagus does not relax) and device erosion (device passing through the oesophageal wall).
A clinical study of 100 patients found that difficulty swallowing (68 per cent), pain (24 per cent), and stomach bloating (14 per cent) were the most common reported problems with the LINX system.
Other risks of the LINX System reported less frequently included hiccups (eight per cent) and nausea (seven per cent). In most cases, the side effects were mild and resolved by three months after the procedure.
A study in June 2017 found that during a four-year period in more than 3000 patients, no unanticipated complications have emerged, and there is no data to suggest a trend of increased events over time.
Post last updated May 2022