Esophageal Magnetic Sphincter Augmentation as a Novel Approach to Post-bariatric Surgery Gastroesophageal Reflux Disease

Obes Surg. 2018 Oct;28(10):3080-3086. doi: 10.1007/s11695-018-3292-y.

Abstract

Background: We sought to evaluate the safety and effectiveness of magnetic sphincter augmentation (MSA) in patients with GERD after bariatric surgery.

Methods: Pre- and post-operative GERD quality of life (G-QOL) surveys were conducted. Standard indications (SI) group or the post-bariatric group (PB) created. Outcomes were compared between groups.

Results: Twenty-eight patients analyzed with no losses to follow-up. All patients had preoperative testing confirming normal motility and presence of GERD. No patients were lost to follow-up. The PB group (N = 10) were mostly prior sleeve gastrectomies (N = 8) with two previous gastric bypasses. PB patients required larger MSA device size (16 beads) compared to the SI group (14 beads, p < 0.001). Outcomes were no different with percent improvement between pre- and post-operative G-QOL survey scores with 70% improvement for PB and 84% for SI (p = 0.13). Medication cessation was possible in 90% for PB versus 94% for SI (p = 0.99). Rates of post-operative dysphagia were similar between the two groups.

Conclusions: Although larger prospective randomized studies are needed, there is an exciting potential for the role of MSA, providing surgeons a new and much needed tool in their armamentarium against refractory or de novo GERD after bariatric procedures.

Keywords: Indications; Magnetic sphincter augmentation; Revisional bariatric surgery; Sleeve gastrectomy.

MeSH terms

  • Bariatric Surgery / adverse effects*
  • Esophageal Sphincter, Lower / surgery*
  • Gastrectomy / adverse effects*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Magnets*
  • Postoperative Complications / surgery*
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome