Linx Flashcards
What factors are associated with the recurrence of reflux symptoms or endoscopic esophagitis in patients on PPIs
The functional status of the lower esophageal sphincter (LES) and esophageal body.
What is the recurrence rate of reflux symptoms in patients with both a defective LES and defective esophageal contractions?
80%
What is the recurrence rate in patients with a defective LES but normal esophageal contractions?
39%
What is the recurrence rate in patients with both a normal LES and normal esophageal contractions?
8%
How does gastric distension after meals affect the LES?
It can cause effacement (flattening) of the LES, leading to progressive shortening of its length and loss of its competency
What happens to the LES and esophagus due to repeated exposure to gastric juice?
The squamous mucosa is destroyed, healing by metaplastic cardiac mucosa, and the LES muscle is permanently damaged, losing length and pressure
What is the concept behind new devices designed to augment LES function?
Placing a loose ligature or ring around the inferior border of the LES to prevent its effacement
What is the LINX Reflux Management System?
A laparoscopic procedure designed to augment the LES as a functional barrier to reflux without altering the gastric or gastroesophageal junctional anatomy.
How does the LINX device work in relation to the LES?
The magnetic attraction between beads prevents LES opening due to effacement and shortening caused by gastric distension
Does the LINX device interfere with swallowing or belching?
No, the beads separate to allow food to pass into the stomach and to relieve gastric distension by belching or vomiting
How long does the surgical time for the LINX procedure typically last?
Less than 1 hour.
When is the patient typically discharged after the LINX procedure?
The same day or, if the procedure is done in the afternoon, the next morning.
instructed to slowly return to a normal diet over the next week
discontinue the use of acid-suppression medication
What is the surgical approach for patients with a hiatal hernia greater than 3 cm?
A more extended and less focused dissection is performed to allow the hernia to be dissected and reduced into the abdomen
Who are the ideal candidates for the LINX device?
Patients with a partial response to PPIs
those who desire to stop PPI therapy
or those with endoscopic/histologic signs of progression while on PPIs
Is a hiatal hernia a contraindication for the LINX device?
No, a hiatal hernia is likely not a contraindication, but long-term data on hiatal hernia recurrence rates are needed
