Post-operative gastroesophageal reflux disease after magnetic sphincter augmentation and transoral incisionless fundoplication

First-line treatment for gastroesophageal reflux disease (GERD) consists of lifestyle modifications and anti-reflux medication with proton pump inhibitors (PPI) being the most common. Approximately 30% of patients continue to suffer despite these medications. New surgical and endoscopic techniques have been developed to treat medically refractory GERD. Nontraditional surgical therapies include magnetic sphincter augmentation (MSA) and transoral incisionless fundoplication (TIF). Initial studies with each of these approaches have demonstrated promising results and their roles in treating reflux are still evolving. Studies for both procedures have demonstrated promising long-term results in regards to reduced PPI usage, symptom relief, and improvement in quality of life. In addition, these procedures have been shown to be safe with a low incidence of adverse events. Although initial studies with each of these approaches have demonstrated promising results, their roles in treating reflux are still evolving. As their roles in anti-reflux surgery continue to expand, this also opens up the potential for complications including dysphagia and persistent reflux disease. The purpose of this review article is to discuss the mechanism of action and outcomes for both MSA and TIF. In addition, we will discuss the evaluation and management of patients who require re-operation for complications following each procedure.