Linx system surgery Part 1 of 2 CLOSED

speden

Good Morning and thank you for the links, WCCO is one of our local stations so it was interesting to read that Debbie Dearborn was in the group receiving the Linx.

She sounds like she is doing well also. 

It is always great to hear good outcomes from new procedures.

Take care,

Kitt

where is shooz......we're eager to know more , shooooz...pls come back!!!

Dear Shooz,
It is great to hear from you. I was telling my friends about this new procedure, and that there is someone nice enough to keep updating the "Gerd Club" about the progression of their healing after this new treatment, and that suddenly they stopped writing... We all laughed a bit (a laugh with a grain of salt as they say). Please do keep updating us. It is very helpful.
Best wishes
Gilad

Hi Gilad,

I'm wondering what the exclusion criteria will be for the Linx as well. The criteria for the clinical study was very strict, probably to allow for the clearest results. If they let people in the clinical trial with more problems than just a defective LES valve, then they wouldn't have known if the treatment failed because the Linx didn't work or because of their other problems (like large hiatal hernia, other previous surgeries, poor esophagus motility, etc.).

I'm hoping once the Linx is FDA approved, they will open it up to anyone that would qualify for Nissen fundoplication. So far the performance of the Linx appears the be similar to Nissen, so it would seem reasonable to let people try the Linx before doing the more radical Nissen procedure. Usually when they do the Nissen they will repair a hiatal hernia at the same time, so I can't see why they couldn't repair a hiatal hernia at the same time as implanting the Linx. But perhaps a hiatal hernia would make the Linx prone to sliding up the esophagus and out of position. The Nissen wrap covers a large area of the esophagus, so positioning of the wrap seems less critical than it is with the narrow Linx. From reading the clinical trial papers, it sounds like the Linx tends to not work unless it is implanted and remains precisely positioned at the Z line. The method of placement at the Z line seems rather hit or miss based on the skill or luck of the surgeon. I wish they had a more foolproof method for seeing the Z line during the implantation procedure, such as a probe that would illuminate the Z line from inside the esophagus (assuming that tissue is thin enough to conduct light). Then the surgeon could see the line of light and cut and implant in just the right spot.

In my situation I have a weak esophagus in addition to a bad LES, so I'm worried they will say my motility is too poor for the Linx. My Doctor suggested I could get a half Nissen wrap since I probably wouldn't be able to swallow with a full wrap. So far it sounds like the Linx only comes in one strength of magnet which corresponds to the strength of a full Nissen wrap. That seems crazy since people with a weak esophagus would want to have weaker magnets than someone with a strong esophagus, so that they would be able to swallow and get food past the Linx. Or someone with a wide open LES would probably need stronger magnets to keep it closed than someone with just a slightly open LES. So I hope they will come up with a variety of strengths for the Linx to match the needs of each individual patient.

speden

Shooz,

I'd like to ask you to clarify a few points for me if you don't mind:

1) Do you sense that your ability to burp is improving, and that perhaps some day in the near future, you may be able to burp any time, just as you did prior to the torax ring?

2) You have mentioned that your doctor said that over time you will no longer notice the pain and issues associated with the food becoming stuck. I want to be sure I understand your viewpoint on this matter. Do you believe that you may simply become so accustomed to the food sticking, that it will no longer tend to bother you, OR, do you believe that your esophagus may adapt to the torax ring in such a way that the food actually no longer gets stuck when swallowing?

3) What were your preop symptoms? Heartburn, I caught that. Any other symptoms? Any LPR symptoms, or more just straight gerd?

4) Any sense on whether you could vomit if necessary? Are you aware of any opinions from the surgeons involved in the study, as to how your anatomy may be adversely impacted (or not) if you were to vomit with an intact Torax ring?

I had considered trying the Torax here in Seattle myself, I called them up and inquired when trials were still open, but now the trials are closed nationwide as I understand it. I'm an LPR'er myself. I chickened out though. Too bad, because I think for LPR'ers, even if the pain of swallowing becomes too severe, it would be such a great experiment just to see whether LES augmentation solves the LPR symptoms.

Anyways, thanks in advance for considering my questions.

I wonder if Shooz is for real.