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NEW LINX DETAILED INFORMATION

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GERD & Acid Reflux
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Posted 4/12/2012 6:32 AM (GMT 0)

The attaached link has some new details info about the Torax linx. interesting data

http://www.toraxmedical.com/linx/downloads/LINXReflux-Management-System-Info-Guide.pdf

Posted 4/12/2012 2:58 PM (GMT 0)
Interesting info Saleen, thanks for posting!

The Table on Page 13 showing GERD symptoms before and after the procedure seems VERY encouraging. The only things that worry me about the device are the potential for long term complications and device migration. It sounds like they think device migration isn't an issue due to tissue encapsulation, so I hope that is the case. I just wonder how it would affect you if you were in a car accident, or jumped on a trampoline, went bungee jumping, etc. I hope they've tested this in some way (with Pigs or something).

Are you thinking of having the procedure done? How long have you had GERD and what are you currently doing to treat it?

I've had very severe GERD (with sudden onset) for about 6 months, and I take 80mg of Nexium a day to control it and it barely does the job. If I have to ride in a car for an extended duration after eating I have to eat tums and swill maalox to avoid continuous symptoms. I'm really hoping that the LINX can solve this issue forever!
Posted 4/12/2012 3:01 PM (GMT 0)
Also was that PDF somewhat corrupted for anyone else? There were several sections where the text was blocked out and I had to copy and paste into a textpad to see it...
Posted 4/12/2012 3:37 PM (GMT 0)
Interesting. The MRI thing is a little concerning but otherwise a glimmer of hope for GERD sufferers
Posted 4/12/2012 4:31 PM (GMT 0)
Ya I agree that the MRI thing is also a bit concerting, but for many things these days a CAT Scan will suffice.

And if something major occurs you can always have the device removed and an MRI performed (i seem to recall someone in the study doing just that).

I've also read that they've tested it with dead pigs and no obvious damage occurred when they put them into an MRI, so someday perhaps even this restriction will be limited.

There's also the hope that MRI machines will get much smaller with much lower magnetism required someday in the future.
Posted 4/12/2012 4:37 PM (GMT 0)
Anyone know how much this surgery costs in the US? I highly doubt my insurance will cover the procedure since it is so new.
Posted 4/12/2012 5:33 PM (GMT 0)
$10,000 - $20,000 USD, I'd guess. It may eventually come down, but there's going to be a lot of demand for it initially and not too many trained practitioners so it will probably be priced a bit high.

I imagine it may eventually go below $10k, but not anytime soon (maybe in 10 years or so?).

And ya, it sucks but I don't think there's any chance insurance companies will cover this until there's long term data on it (>5 years or maybe even > 10 years).
Posted 4/12/2012 6:35 PM (GMT 0)

If the same doctor does NF as well as LINX, and the doctor recommends LINX, why would the insurance company not cover it....This might be actually cheaper for the insurance companies than the NF

Raj

Posted 4/12/2012 6:56 PM (GMT 0)
Interesting that they say the only thing that rules out using the Linx on someone is if they have a metal allergy. For things like hiatal hernias, barrett's, etc., they seem to be saying it's up to the surgeon to decide.

For the clinical trial they had very tight restrictions against those things. But in this paper they don't really say those things exclude people from getting the Linx, just that it hasn't been studied in people with those things.
Posted 4/12/2012 7:21 PM (GMT 0)
Barretts is a surgeon call, and some surgeons will fix the HH, and then put the Linx in, sort of a Hybrid-Linx as they do tif-hybrids as well.
Posted 4/12/2012 7:57 PM (GMT 0)
Raj-

I would think the Linx would be cheaper for the insurance companies than the NF because it is not uncommon for the NF to have to be re-done, and the Linx claims to stay in place permanently. However, I think that in the long run the Linx could cost insurance companies more because more people would want to have the Linx than the NF, given the potential complications of the latter.

There are good arguements for and against covering the device. I guess we just have to wait and hope. It's unfortunate that insurance companies are in the business of making money, and not in the business of doing what is best long-term for the patient.

I'm tempted to call UPMC (the closest facility to MD) to find out the specifics (i.e. cost), but since I've only had a barium swallow thus far, I know I have a lot of tests to go before I could be considered for the procedure. I aslo have a small hiatal hernia; I've read in other posts that the Mayo Clinic in Florida will not put the device in someone with a hernia, depsite the fact that it supposedly works with hernias smaller than 3cm.  

Torax's website does have an e-mail address for a doctor performing the surgery in GA. Just throwing that out there in case anyone is interested in contacting him. For all other facilities, it's just phone numbers. "Hold please."

Posted 4/12/2012 9:32 PM (GMT 0)
How do you know if you're allergic to nickel? Would they test that before you have the procedure done?
Posted 4/12/2012 10:47 PM (GMT 0)
A lot of cheap jewelry contains nickel. If you are sensitive to nickel and wear, for example, a ring that contains it, it will likely turn your finger very red and will cause inflammation and possibly itching. At this level, the exposure isn't going to kill you, but I can imagine it would do a great deal of damage inside your body if you were allergic to it. Therefore, I would hope if there were any question, your doctor would test for the allergy in advance.
Posted 4/12/2012 11:38 PM (GMT 0)
The biggest concern I would have if I was looking at this procedure would be from their own info on the website - "The LINX system should not be used with electrical implants ( cardiac pacemakers and inplantable defibrillators ) or metallic implants in the stomach."

If you have a need for a pacemaker or defibrillator does the LINX have to be removed - if I was in a situation that called for a pacemaker to keep my heart going I cannot imagine having to have surgery first to remove the LINX.  smhair Just my imagination running as I like to know how the whole system works.

I am sure this will be a procedure many people will choose even if they have to pay out of their pocket but I suspect the guesses putting the cost at $10,000.00 may be low.  Don't forget the OR expenses, the surgeons bill, anesthesia, medications etc.

Interesting discussion.

Kindly,

Kitt

Posted 4/13/2012 1:39 AM (GMT 0)
Kitt, good points, but fortunately they could pace your heart prior to taking the Linx out. Question would be - is it a true emergency, or can rhythm meds keep you going until the Linx removal and following pacemaker implant?
Posted 4/13/2012 8:28 AM (GMT 0)

Speedygerd,

I've been researching the linx so I can decide if it's best for me or if I should go with the Nissen.  I've had servere heartburn for more than ten years and have been on every PPI there is and  lots of Zantacs, etc

I've located Doctors in my area who did some of the linx surgery's during the clinical research,  but have not made the appointment to see them yet due to the insurance not paying.  I called my insurance and they of course had nothing listed for it.  Both my GI Dr and GI Surgeon feel there is just not enough long term data on the linx and they feel the NF would be better.  I'm willing to wait through the summer and see what else comes up about the Linx.  I've been trying to make some life style changes, along with apple cider vinegor, chewing gum and drinking a green drink in the mornings and I can honestly say that I have felt better than I have in a long time.  I'm not sure if it's in my head or if these minor changes really work. I've also just cut down on my PPI dose and now only taking one Zantac a day. I'll keep researching the Linx and post more as I hear or see new info.

Thanks

SL

Posted 4/13/2012 9:18 PM (GMT 0)
hit the post,

I agree with you that it would depend on whether it is a true emergency and if it is there are several things you could do if it is a pacemaker that is needed. Temporary systems use an external pulse generator with leads placed either transcutaneously or transvenously. Transcutaneous leads are the easiest and most convenient to use for rapid application of temporary pacing and is the method of choice during ED resuscitation. Transcutaneous pacing may be uncomfortable, and patients may require mild sedation (eg, benzodiazepine). Once the patient is stabilized or central venous access is gained, transvenous leads provide the most reliable and comfortable pacing mechanism and are a good transition to permanent systems. And of course if you present in Pulseless V-Tach or V-Fib well hopefully you can be converted with a defibrillator.  

I guess we will leave this problem to the Drs. that run into patients with the LINX device.

Good comments.

Kitt

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