Albany physicians sold on benefits of LINX acid reflux surgery

ALBANY — The physicians at Albany Surgical have performed more than 500 LINX surgeries, a minimally-invasive procedure meant to bring permanent relief to patients with acid reflux.

Shortly after reaching the milestone, Drs. Chris Smith, J. Price Corr and John “Buck” Davis talked about how they have seen this procedure benefit their patients when compared to other methods used to treat acid reflux. The LINX Reflux Management System, or LINX device, offers an alternative to traditional surgery and has shown favorable results.

Physicians with the practice began performing the procedure as early as 2006 during a study and trial period prior to its formal approval by the Food and Drug Administration in 2012.

“We were among the first surgeons in the world to do this,” Smith said. “We were the only ones in the state for a long period.”

The LINX device is designed to treat patients with severe heartburn or gastroesophageal reflux disease. It augments the lower esophageal sphincter. The quarter-sized device, made up of magnetized titanium beads connected by titanium wires, prevents stomach acid from entering the esophagus.

The device is placed around the lower esophagus just above the stomach. The magnetic beads constrict to prevent acid from escaping the stomach while allowing the patient to eat and swallow normally.

Uncontrolled regurgitation indicates a mechanical failure of the lower esophageal sphincter, the body’s natural barrier to reflux. Medications such as proton pump inhibitors are designed to suppress acid production, but they do not address the mechanical failure of the reflux barrier.

The LINX procedure is done using a camera and tools placed through five small incisions, which minimize the recovery time and risks to patients. The procedure typically lasts between 40-60 minutes, and patients can resume a normal diet that night.

A procedure commonly referred to as laparoscopic nissen fundoplication involves reinforcing the “valve” between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus.

This is known as a “wrap” surgery.

“(LINX) is just as good as the wrap without the baggage,” Smith said. “You can vomit or burp without restriction.”

LINX can be done on an outpatient basis and has shown to have a drastic impact on Barrett’s esophagus, a condition in which tissue in the esophagus is replaced by tissue similar to the intestinal lining — which is associated with an increased risk of developing esophageal cancer.

Smith said about 75 percent of Barrett’s esophagus, connected to long-term acid reflux, is resolved as a result of LINX.

“It can prevent long-term reflux,” he said.

Since the LINX is made of magnets, they are likely to last a long time — if they wear out at all. The procedure is also not quite as specialized as some used to treat acid reflux.

“The surgery is a bit more standardized,” Davis said. “I have seen patients’ lives improve dramatically. Their quality of life is improved; they are not on medication and they are happy.”

Smith said it has gotten easier over the last few years to get health insurance approval, making LINX more accessible. Patients from Florida, South Carolina, Tennessee and Alabama are coming to the physicians at Albany Surgical to get the surgery.

“Reflux can impact everything you do,” Smith said. “(When it is resolved) people can eat a meal and go dancing. That is remarkable (when considering) they couldn’t bend over before.”

The practice is even getting referrals from dentists who have seen the impact of acid reflux on teeth. Smith said the staff at Albany Surgical will conduct pH monitoring to establish conclusively that acid reflux has been the underlying cause of a patient’s health issues.

“Medications don’t protect the teeth, they don’t protect the lungs, they don’t protect the sinuses,” Smith said. “Nobody has connected all the dots that it is reflux.”

Corr called himself a “late bloomer,” hesitant to trust LINX at first. He said he questioned why a foreign body would be inserted. Then he did more research on the wrap procedure.

“It (the LINX) doesn’t take as much artistry as putting in a wrap,” he said. “One thing that got my attention is that (with a wrap) that hiatal hernia had a high recurrence, because the wrap was intact and beating on the hernia.”

Just a short time ago, Corr was not confident enough to recommend a LINX. Since he was sold on the procedure, though, he has inserted 25 of them.

“I am not taking them out, and they (the patients) are doing great,” he said.

The vessels in the area of the LINX surgery are left intact, which is also beneficial for the patients in the long-term picture.

“It doesn’t burn any bridges, and that is helpful,” Corr said.

The physicians at Albany Surgical said a work-up is done to determine who is a good candidate for LINX. Reflux is a progressive disease, a point Smith made by telling the story of a patient he once had who was relying on an oxygen tank because of how severely his lungs were damaged.

“Nobody ever offered him any other options,” the physician said.

The physicians at the practice said medications are not meant for long-term use, and when used on a long-term basis, can even impact the ability to absorb nutrients the body needs. Patients can still reflux, they are just not refluxing acid.

“I think it’s a misconception that medications can fix the issue,” Davis said. “You have to fix the anatomy.”

Smith said 92 percent of LINX patients are not suffering from regurgitation. As time has passed, he and his cohorts said the benefits of the procedure have caught on.

“It is nationally being recognized more and more,” Davis said.

More information on LINX can be found at toraxmedical.com/linx.

Jennifer Parks