Abstract Introduction One of the common complications after sleeve gastrectomy (SG) is de novo reflux. Although RY gastric bypass (RYGB) has been considered the best option for patients with severe obesity and GERD, some patients still complain of persistent GERD. RYGB was the treatment of choice or management of GERD post one anastomosis gastric bypass (OAGB). A new technique is to use lower esophageal sphincter magnetic augmentation (LINX). Methods We reviewed the outcomes of our patients who completed at least twelve months follow up after insertion of LINX post bariatric surgery including sleeve gastrectomy, one anastomosis gastric bypass and RY gastric bypass. We assessed the patients using GERD-HRQL score and proton pump inhibitors (PPI) usage. Results Thirty-one patients were operated (25 female and 6 male) with age of 21–59 year. BMI was 19.1–34 kg/m2 at time of surgery. The index surgery was 22 SG, 7 RYGB (one of them was converted from SG to RYGB before she had LINX inserted) and 2 OAGB. Mean interval period from index bariatric surgery was 49.2 ± 30.2 months (6 to 108 months). The follow up was 37.7 ± 19.7 months (12 to 72 months). GERD- HRQL score improved from 46.8 ± 10.4/75 to 11.4 ± 12.3/75 (P 0.00001). PPI usage decreased from 49.6 ± 18.2 mg preoperatively to 10.3 ± 15.9 mg post operatively (P 0.00001). Two patients underwent removal of the device with conversion to RYGB (one patient for symptoms recurrence and another for weight gain). One post SG patient had recurrent reflux (GERD—HRQL 27) that was confirmed by 24 h Ph monitoring (DeMeester Score 24). However, he was satisfied with his quality of life. All cases were completed laparoscopically. There were zero mortality and no device erosion or slippage. Conclusion Using LINX for management of GERD post bariatric surgery is safe. It can be a tool in armamentarium of treatment of reflux after bariatric surgery specially for those with GERD and optimal clinical response after their bariatric procedures.
Alayed et al. (Thu,) studied this question.