Fundoplication or LINX®?

I need to have an operation for acid reflux. Should I have Nissen fundoplication or the LINX ® Magnetic Bead Ring?

Several studies have compared Nissen fundoplication and LINX®:

The success of both operations is roughly the same. The control of acid reflux, in terms of patient-satisfaction, improvement in quality of life, and ability to stop PPI medicines is similar.

The main side-effect of both operations is difficulty to swallow. The occurrence and severity of swallowing difficulties seem to be equal.

Gaseous bloating of the abdomen and excessive flatulence are less severe with LINX®. Such ‘gassy’ symptoms can be very troublesome after fundoplication.

Difficulty to belch and vomit seems less with LINX® than with fundoplication.

LINX® does not distortion the anatomy of the oesophagus (gullet) and the stomach. Although there are no studies on this topic, it seems logical that any re-operation after LINX® will be simpler and safer than after fundoplication.

The fundoplication is a time-tested operation. LINX® is a new procedure. Although it seems very promising, we do not know about long-term success or problems.

Up to now, LINX® was not recommended if you have a large hiatus hernia, severe inflammation of the gullet, Barrett’s oesophagus, stricture or previous surgery on the stomach or gullet. But, recent studies show that LINX® can work even if you had an operation previously on the gullet or stomach, or if you have a hiatus hernia. With regard to previous surgery, LINX® may be an attractive option if you have troublesome reflux after sleeve gastrectomy for weight loss.

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