Reflux management systems

Last revised by Hamish Smith on 6 Aug 2018

Reflux management systems refer to medical devices that offer an alternative to surgical based treatments for severe and medically refractory gastro-esophageal reflux disease.

Indications for the surgical management of gastro-esophageal reflux disease include gastro-esophageal reflux disease related asthma or chest pain, medication resistant reflux disease, complications of gastro-esophageal reflux disease (e.g. Barret esophagus, stricture formation) and patient preference 1. The LINX Reflux Management System ® is probably the best known device of this type 1.

The device is inserted laparoscopically and sits around the esophagus. It consists of an expandable ring, comprised of a series of interconnected titanium beads with magnetic cores. Attraction between the beads aids in increasing lower esophageal tone and prevents the reflux of acid. The magnetic attraction is overcome by food and liquid in the esophagus allowing ingested material to enter the stomach 1,2.

Radiographic appearance

The device appears as a series of metallic beads positioned over the gastro-esophageal junction on radiograph 1.

Complications

  • dysphagia
  • erosion of the esophagus 3
  • device migration and breakage of the ring are potential complications, but have not been reported 1

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