Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group sphincter device eliminates reflux symptoms

Posted on this a couple of months ago - gastro / Reflux / LPRD/ GERD refers.

'This' being the small intervention using the titanium beads: the laparoscopically implanted sphincter augmentation device for the treatment of gastroesophageal reflux disease. Here is an Update on the procedure - following 1yr and 2yr trials. Great *success.

http://www.ncbi.nlm.nih.gov/pubmed/21037442?dopt=Abstract

Ann Surg. 2010 Nov;252(5):857-62.

Laparoscopic sphincter augmentation device eliminates reflux symptoms and normalizes esophageal acid exposure: one- and 2-year results of a feasibility trial.
Bonavina L, DeMeester T, Fockens P, Dunn D, Saino G, Bona D, Lipham J, Bemelman W, Ganz RA.

Department of Surgery, University of Milano Medical School, IRCCS Policlinico San Donato, Milan, Italy. luigi.bonavina@unimi.it

Abstract
OBJECTIVES: One-and 2-year evaluation of a feasibility trial (clinicaltrials.gov registration numbers NCT01057992, NCT01058070, and 01058564) to assess the safety and efficacy of a laparoscopically implanted sphincter augmentation device for the treatment of gastroesophageal reflux disease (GERD).

METHODS: A sphincter augmentation device (LINX Reflux Management System; Torax Medical, Shoreview, MN), designed to prevent reflux due to abnormal opening of the lower esophageal sphincter (LES), was laparoscopically implanted at the gastroesophageal junction in 44 patients. At baseline, all patients had abnormal esophageal acid exposure on 24-hour pH monitoring and improved, but persistent, typical GERD symptoms while on acid suppression therapy with proton pump inhibitors (PPIs). The device comprises a miniature string of interlinked titanium beads, with magnetic cores, placed around the gastroesophageal junction. The magnetic bond between adjacent beads augments sphincter competence. The beads temporarily separate to accommodate a swallowed bolus, allow belching or vomiting, and reapproximate to augment the LES in the closed position. Patients were evaluated after surgery by GERD Health-Related Quality of Life symptom score, PPI usage, endoscopy, esophageal manometry, and 24-hour esophageal pH monitoring.

RESULTS: The total mean GERD Health-Related Quality of Life symptom scores improved from a mean baseline value of 25.7 to 3.8 and 2.4 at 1- and 2-year follow-up, representing an 85% and 90% reduction, respectively (P < 0.0001). Complete cessation of PPI use was reported by 90% of patients at 1 year and by 86% of patients at 2 years. Early dysphagia occurred in 43% of the patients and self-resolved by 90 days. One device was laparoscopically explanted for persistent dysphagia without disruption of the anatomy or function of the cardia. There were no device migrations, erosions, or induced mucosal injuries. At 1 and 2 years, 77% and 90% of patients had a normal esophageal acid exposure. The mean percentage time pH was less than 4 decreased from a baseline of 11.9% to 3.1% (P < 0.0001) at 1 year and to 2.4% (P < 0.0001) at 2 years. Patient satisfaction was 87% at 1 year and 86% at 2 years.

CONCLUSIONS: The new laparoscopically implanted sphincter augmentation device eliminates GERD symptoms without creating undue side effects and is effective at 1 and 2 years of follow-up.
PMID: 21037442 [PubMed - indexed for MEDLINE]

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Woo-Hoo. Terrific. Now (!!) to find out IF this procedure is available in France...

The word "sphincter" has to be one of the coolest sounding words in the English language (IMHO).

It brings a tear to my eye!

Molly - tell the truth. You posted this JUST so you could use the word "sphincter" didn't you. ;-D

Oh geeeeee - I've bin rumbled! <LOL>

Only 'this' sphincter is at the top end...make ya feel betta? (No? Oh shoot!)

Thank you for posting this. Looks like good news for people with GERD.

I posted on it about three months ago (and two years ago) even posted a 'visual' of the op - facinating. Should be there in KA posts, main forum. Sue22 responded, as thought it 'might' be useful for her husband, but she thought he would not be prepared to 'go' for it.

I'm certainly going to check it out over here. As the procedure is available in Italy, then it might, just 'might' be available in France, though 'probably' NOT in my neck of the boony woods - Paris 'possible'!

Yes. Assuredly good news for those with LPRD / GERD / Reflux. As those PPIs are now found to throw bad side effects, including osteoporosis - not good and more important not good news for AS patients who are inclined to osteoporosis as indeed are all those suffering from inflammatory diseases.

Yep. Way to go - and looking even better with a good/proven 2yr track record.

I had to double take when I saw this since I forgot that the stomach sphincter even existed. I was only thinking of the other one.

ah, you brought back some old memories, Molly!

FIELD TRIP!!

Creating the stomach sphincter sound effects in this crazy episode was a fun challenge!

Bl...y **Brilliant. Great 'squelsch' sounds...haha Good movie. Interesting and well put together. Dow, you are ace (I was left trying to 'think' what y'all might do with the 'end' product...!! Called, leavethat bit out! <LOL>)

What a hoot and Well done man.

sent on to hubby, thanks, along with post about detecting early esophageal cancer cells.

think he may be able to avoid this surgery, now that reflux under control, but if it doesn't stay that way.............

i think i know him well enough, he'd probably choose the drugs over the surgery as surgery comes with risks.....he won't even consider surgery for now on his back, so going inside, i doubt even more, but i've given him the info, so he can make his own decisions. best to be informed, so thank you for helping with that.