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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2015

01-12-2015 | Dynamic Manuscript

Endoluminal perforation of a magnetic antireflux device

Authors: Margit Bauer, Alexander Meining, Michael Kranzfelder, Alissa Jell, Rebekka Schirren, Dirk Wilhelm, Helmut Friess, Hubertus Feussner

Published in: Surgical Endoscopy | Issue 12/2015

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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.
Appendix
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Literature
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Lipham JC, Taiganides PA, Louie BE, Ganz RA, DeMeester TR (2014) Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease. Dis Esophagus (Epub ahead of print)
2.
Feussner H, Horvath OP, Siewert JR (1992) Vicryl-scarf-induced scarring around esophagogastric junction as treatment of esophageal reflux disease. An experimental study in the dog. Dig Dis Sci 37(6):875–881CrossRefPubMed
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Siewert JR, Feussner H (1988) The Angelchik prosthesis—intermediate term evaluation and results. Z Gastroenterol 26(8):421–429PubMed
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Bonavina L, DeMeester T, Fockens P, Dunn D, Saino G, Bona D et al (2010) Laparoscopic sphincter augmentation device eliminates reflux symptoms and normalizes esophageal acid exposure: one- and 2-year results of a feasibility trial. Ann Surg 252:857–862CrossRefPubMed
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Bonavina L, DeMeester T, Mason R, Stein HJ, Feussner H, Evander A (1997) Mechanical effect of the Angelchik prosthesis on the competency of the gastric cardia: pathophysiologic implications and surgical perspectives. Dis Esophagus 10(2):115–118PubMed
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Bonavina L, Saino G, Lipham JC, DeMeester TR (2013) LINX® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux: a novel effective technology for restoring the natural barrier to reflux. Ther Adv Gastroenterol 6(4):261–268CrossRef
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Ganz RA, Peters JH, Horgan S, Bernelman WA, Dunst CM, Edmundowicz SA, Lipham JC, Luketich JD, Melvin WS, Oelschlager BK, Schlack-Haerer SCJ, Smith CD, Smith CC, Dunn D, Taiganides PA (2013) Esophageal sphincter device for gastroesophageal reflux disease. N Engl J Med 368(8):719–727CrossRefPubMed
Metadata
Title
Endoluminal perforation of a magnetic antireflux device
Authors
Margit Bauer
Alexander Meining
Michael Kranzfelder
Alissa Jell
Rebekka Schirren
Dirk Wilhelm
Helmut Friess
Hubertus Feussner
Publication date
01-12-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 12/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4145-6

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