The current status of magnetic sphincter augmentation in the management of gastroesophageal reflux disease

Mazen R. Al-Mansour, Kyle A. Perry, Jeffrey W. Hazey


Magnetic sphincter augmentation (MSA) using the LINX® Reflux Management System is a surgical option for the management of gastroesophageal reflux disease (GERD). This technique involves the laparoscopic placement of a band of magnetic beads around the distal esophagus. The beads augment the function of lower esophageal sphincter (LES) by preventing the proximal reflux of gastric contents at rest, while expanding during swallowing to allow the unimpeded passage of food boluses. Despite the lack of randomized controlled trials evaluating the efficacy of MSA, recent long-term retrospective studies support the procedure’s safety and efficacy in controlling reflux symptoms and improving quality of life. When compared to laparoscopic fundoplication for the management of reflux, MSA has shown comparable symptoms control and acceptable side effect/complication profile. Complications including dysphagia and erosion have been described. The device can be removed laparoscopically if intolerance or complications develop. Careful patient selection is paramount in order to select the appropriate patients for this technique.