Margit Bauer1, Alexander Meining2, Michael Kranzfelder3, Alissa Jell3, Rebekka Schirren3, Dirk Wilhelm3, Helmut Friess3, Hubertus Feussner4. 1. Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. margit.bauer@tum.de. 2. Department of Internal Medicine I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. 3. Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. 4. Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. hubertus.feussner@tum.de.
Abstract
BACKGROUND: The history of surgical antireflux treatment is coined by the search for better alternatives to Nissen fundoplication. Implantable devices are one option, beginning with the "Angelchik" prosthesis 30 years ago. However, this procedure was left soon because of the high rate of foreign body connected problems (migration, perforation). A modern approach is a magnetic sphincter augmentation device (LINX Reflux Management System, Torax Medical, Shoreview, MN, USA), a magnetic chain which is implanted laparoscopically. Advantages reported are simplicity to apply and good results in reflux control, with up to now only rare complication rates as reported in the literature (Lipham et al. in Dis Esophagus, 2014). METHODS: We report one case of erosion of the esophagus by a LINX system resulting in severe dysphagia. RESULTS: A complete endoluminal removal could be achieved by a prototype OTSC-clip remover. Complete remission could be achieved. The technique is presented in detail (video). CONCLUSIONS: In principle, total endoscopic removal of the LINX device is feasible in case of major erosion.
BACKGROUND: The history of surgical antireflux treatment is coined by the search for better alternatives to Nissen fundoplication. Implantable devices are one option, beginning with the "Angelchik" prosthesis 30 years ago. However, this procedure was left soon because of the high rate of foreign body connected problems (migration, perforation). A modern approach is a magnetic sphincter augmentation device (LINX Reflux Management System, Torax Medical, Shoreview, MN, USA), a magnetic chain which is implanted laparoscopically. Advantages reported are simplicity to apply and good results in reflux control, with up to now only rare complication rates as reported in the literature (Lipham et al. in Dis Esophagus, 2014). METHODS: We report one case of erosion of the esophagus by a LINX system resulting in severe dysphagia. RESULTS: A complete endoluminal removal could be achieved by a prototype OTSC-clip remover. Complete remission could be achieved. The technique is presented in detail (video). CONCLUSIONS: In principle, total endoscopic removal of the LINX device is feasible in case of major erosion.
Authors: Luigi Bonavina; Tom DeMeester; Paul Fockens; Daniel Dunn; Greta Saino; Davide Bona; John Lipham; Willem Bemelman; Robert A Ganz Journal: Ann Surg Date: 2010-11 Impact factor: 12.969
Authors: John C Lipham; Tom R DeMeester; Robert A Ganz; Luigi Bonavina; Greta Saino; Daniel H Dunn; Paul Fockens; Willem Bemelman Journal: Surg Endosc Date: 2012-04-27 Impact factor: 4.584
Authors: Robert A Ganz; Jeffrey H Peters; Santiago Horgan; Willem A Bemelman; Christy M Dunst; Steven A Edmundowicz; John C Lipham; James D Luketich; W Scott Melvin; Brant K Oelschlager; Steven C Schlack-Haerer; C Daniel Smith; Christopher C Smith; Dan Dunn; Paul A Taiganides Journal: N Engl J Med Date: 2013-02-21 Impact factor: 91.245
Authors: Evan T Alicuben; Reginald C W Bell; Blair A Jobe; F P Buckley; C Daniel Smith; Casey J Graybeal; John C Lipham Journal: J Gastrointest Surg Date: 2018-04-17 Impact factor: 3.452
Authors: James M Tatum; Evan Alicuben; Nikolai Bildzukewicz; Kamran Samakar; Caitlin C Houghton; John C Lipham Journal: Surg Endosc Date: 2018-11-01 Impact factor: 4.584
Authors: Greta Saino; Luigi Bonavina; John C Lipham; Daniel Dunn; Robert A Ganz Journal: J Laparoendosc Adv Surg Tech A Date: 2015-10-05 Impact factor: 1.878