If you are at all interested in a surgical option as a long-term management strategy for GERD, you have come to the right place. The purpose of this page is not to tell you what procedure you should have; rather, what procedures you can have. It would not be appropriate to recommend any one procedure for every patient: that is a decision between you and your surgeon. The truth is that you are the most important part of that calculation. It is important that you are fully aware of the spectrum of treatments and the potential side effects prior to making a decision; and, if you are better informed before you see your doctor, your discussion with him or her will be much more meaningful.
On this page is a four-part video series that will guide you through the process and be a starting point. Each video is 10 minutes or less. My goal is that by spending 1-2 hours on this site, and associated links, you will become as much of an expert on GERD as a non-medical person could be.
There are three general surgical interventions available at this time. They are all quite different, and some are more heavily marketed than others. I will provide the links to the sites for each procedure. These sites will of course present their respective procedures as the sole option, which is of course not the case.
I will provide links to pertinent medical studies and other information that you may find helpful.
If the video slider doesn’t work for you in your browser, the videos are also displayed linearly in this blog post.
There is no one site for the Nissen in the sense of a vendor, as there is with the other two surgical options because a Nissen, or partial wrap, can be done in slightly different ways by different surgeons, and is the oldest surgical treatment for GERD. The best description, free of bias, good pictures, at this time, on my brief search, is Wikipedia, and this is simply a review of what I’ve addressed in my video series.
The LINX device is a Magnetic Sphincter Augmentation (MSA). This is one of the vendor’s websites. This is another one with better pictures and explanation of the device. Understand that the company does and should list the reported side effects. These specific side effects and concerns thereof should be carefully explored and addressed with your surgeon.
The makers of the TIF device, EndoGastric Solutions, have a couple of good websites with good information. The primary vendor site is here; and, the more patient oriented site is here. Although the TIF procedure is about as new as the LINX procedure, it is quite similar to the Nissen and other partial wraps that have been done for over 50 years, and there is no implantation of a foreign body, other than the suture material itself. Understand that the company does and should list the reported side effects. These specific side effects and concerns thereof should be carefully explored and addressed with your surgeon.
When reading Medical Literature
- Assign more value to the most recent data.
- Assign more value to data accessible on the NCBI/NIH network and in major medical journals that are obvious by their name generally.
- Focus on the discussion or summary of an article as it will be more readable.
- If you don’t understand something and are concerned about it, ask your surgeon or doctor.
Side Effects of long-term PPIs
This is a fairly recent review article on the listed side effects of PPIs. It addresses all of the side effects that are pertinent, and summarizes the increased risk at the end of each individual complication under “Discussion.” There is a “Discussion” for each side effect.
5 Yr. data on the TIF procedure
Safety and Effectiveness of LINX
SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) publishes data on LINX that is periodically updated and can be found here.
Three factors predicting poorer outcomes of LINX
There are some clinical cases where the LINX procedure may be less beneficial; obesity, and abnormal esophageal motility.