For patients who find dietary and lifestyle changes, as well as over the counter and prescription medications, do not adequately control their GERD symptoms, there is an alternative therapy. Magnetic sphincter augmentation (MSA) may be the answer.
At Mayo Clinic, your GERD care team includes experts trained in digestive diseases (gastroenterologists) and chest surgery (thoracic surgeons). This ensures that every test and procedure you receive is designed to address your unique needs.
LINX® Reflux Management System
Medications for gastroesophageal reflux disease (GERD) can control or suppress acid production, but they can’t do anything to prevent acid from rising into the esophagus. The LINX® Reflux Management System solves this issue by strengthening the weak sphincter that controls reflux.
During a minimally invasive surgical procedure, a flexible string of titanium beads is placed as a ring around the LES. When patients swallow, the rings open temporarily to allow food and liquid to enter the stomach, but quickly close to keep acid from moving up into the esophagus.
Two independent clinical trials have shown that the LINX Reflux Management System is safe and effective in decreasing esophageal acid exposure, reducing GERD symptoms and improving quality of life. It is also the first reversible implant to demonstrate that the sphincter barrier can be strengthened without altering gastric anatomy.
Each year, Mayo Clinic specialists diagnose and treat about 50,000 adults and children with GERD. They’re skilled at distinguishing GERD from other illnesses that might cause similar symptoms and are experienced in using intraluminal esophageal impedance monitoring to detect reflux, even when proton pump inhibitors fail to control symptoms.
In surgery, surgeons can restore the lower esophageal sphincter’s one-way valve function by wrapping a portion of the stomach around it. This procedure, known as laparoscopic fundoplication, is the most common surgical treatment for GERD.
In 2014, Mayo Clinic President Gianrico Farrugia promised to cut costs—but “pass the savings on to patients.” Since then, the hospital has pursued hundreds of projects aimed at taming costs.
da Vinci® Surgery
The FDA-approved da Vinci system allows surgeons to perform complex surgical procedures through a few small incisions. This minimally invasive procedure allows for a quicker recovery from surgery so patients can get back to their lives sooner.
In a traditional laparoscopic anti-reflux operation, surgeons make small incisions in the abdomen, insert long thin instruments with a camera attached to them, and then view the inside of your body on a monitor. This allows doctors to see and reach areas of your stomach and esophagus that would be difficult to get to with a regular scalpel.
The da Vinci robot, developed by Intuitive Surgical, has three robotic arms with a high-definition camera and surgical tools that are controlled by your surgeon from an operating room console. The da Vinci system offers surgeons greater dexterity and precision, as well as a more ergonomic platform. However, the company’s devices have been linked to some complications. Surgeon inexperience has been cited as one of the biggest reasons for these complications.
While it hasn’t been compared to LINX surgery, robotic antireflux procedure is another option for GERD patients. This technique, called fundoplication, supports the weakened LES (lower esophageal sphincter) by wrapping the top of the stomach around the bottom portion, creating a ‘bolster’ that stops acid backflow from the esophagus into the stomach.
Robotic surgical systems use three to four robotic arms that insert into the patient through small incisions. The surgeon sits at a console and controls the arms while an assistant stands by.
This technology allows physicians to perform more difficult surgeries through smaller incisions with extreme precision. It also reduces hand tremors and provides more ergonomic working conditions for surgeons. It can even allow surgeons to work from home. The current system can also relay data to other locations for intraoperative consultation or guidance. This can lead to remote surgery and AI-assisted surgery in the future. However, more high-quality clinical trials are needed before these advances can be fully realized.