New technology minimally invasive for the treatment of gastro-esophageal reflux disease: LINX

Abstract

: Gastroesophageal reflux disease (GERD) is a common disorder worldwide (10–30% of adults); lifestyle modifications and PPI therapy (the gold-standard medical treatment for GERD) work in many patients with GERD but in 30–40% of them symptoms persist. Anti-reflux surgery is indicated, with moderate level of evidence, in PPI-resistant GERD patients and with low level of evidence in erosive GERD patients on long term PPI treatment. LINX Reflux Management System (Torax Medical, Maple Grove, MN) is a device for magnetic sphincter augmentation (MSA) and is gaining interest as a valuable surgical alternative approach in patients with GERD, compared to laparoscopic Nissen fundoplication (LNF) which is nowadays the gold-standard surgical technique. In this brief review of current literature in order to compare LINX to the gold-standard surgical procedure for GERD, we analyzed two reviews and three meta-analyses. Each Authors confirmed the efficacy and safety of both techniques. LINX seems to have shorter operative time, shorter length of stay and fewer complications of gas and bloating, if compared to standard surgical procedure. In all analyzed studies the presence of hiatal hernia (HH) larger than 3 cm was often an exclusion criterion for LINX. No RCTs are currently available in literature in order to compare LNF vs. LINX and future researches are needed.