HealingWell
Search Close Search
☰

Just curious. Why have the nissen when the LInx is available

Support Forums
>
GERD & Acid Reflux
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/8/2013 2:06 PM (GMT 0)
Just curious. Why are folks continuing with the nissen when the LInx is available. I know the LInx is new. I have worries as well. But he nissen seems to have more side effects?
I was ready to ahead with the nissen but my doc said the LInx was better for me. He didn't say why. I will ask this we'd.
Posted 7/8/2013 2:17 PM (GMT 0)
My surgeon and my GI gave me horror stories about the LINX so I got a bit freaked. I also studied Biophysics at uni and the whole magnet in the abdominal cavity is all a bit weird.

I'm sure it will be more refined in the future but for me there is no way I would of gone for that.

Having said that though, there are certainly some horror stories re the NISSEN.

My wrap is my baby and I dont think I could feel as attached to a ring of magnets smilewinkgrin

Posted 7/8/2013 6:52 PM (GMT 0)
I don't think the LINX is covered by a lot of insurance companies yet and people are concerned about the long term effects.
Posted 7/8/2013 7:29 PM (GMT 0)
For me, linx is just too new. To be honest, my concern is with scar tissue or just tissue in general growing around the magnets over the years (10/20 + yrs). This isn't plates or screws on/in bone, this is an organ.
Posted 7/8/2013 9:40 PM (GMT 0)
My surgeon said they don't do that procedure because it just wasn't reliable enough. Not everyone is even a candidate for LINX. If you have a hiatal hernia needing repair it's not for you. You can't ever have an MRI either because of all the metal.
Posted 7/8/2013 10:16 PM (GMT 0)
I suspect the reason patients continue to choose Nissen is because insurance companies are not ready to pay the cost of the LINX procedure or it is not available in their part of the country.

JMHO

Kitt :-)

Posted 7/9/2013 12:39 AM (GMT 0)
Insurance is a major reason, including that nobody wants to have to pay for major surgery out of their pocket. Still, the biggest is probably the fact that there are no long term data since it has only been in trials for less than a decade.

Also, although it may be available in many parts of the country, very few surgeons have had enough experience to do it perfectly, much like the nissen. Through all of this, the only thing stopping me is the fact that the minimum age is 21 and I am 18 and they actually stand by that rule.
Posted 7/9/2013 2:19 AM (GMT 0)
Hi Teacherman,

My GI docs weren't a bit impressed with the track-record of the LINX.  The Nissen, on the other hand, continues to be the "gold standard" for stopping reflux.  The procedure has been done successfully for over 50 years, and when done by a skilled and experienced surgeon on a person who is well suited for the procedure, there are few side effects after recovery. 

Personally, the idea of having a ring of magnets in my chest cavity, and the possibility of tissue erosion is enough to make me decide to go with the Nissen surgery.  The LINX hasn't been around long enough to judge what its long term success rate will be.  That's why the insurance companies haven't jumped on board the LINX wagon.

It may very well prove to be a great option and provide excellent long-term results.  Time will tell.  I had the Nissen four and a half years ago, and have had great results.  My lungs were very sick from reflux, and the surgery gave me back my lung health. 

Good luck,

Denise

Posted 7/9/2013 10:04 AM (GMT 0)
Alcie,

You mentioned MRIs can't be done after the linx. Do you think the metal stitches used for the Nissen will be ok? I need to find out what they're made from. I couldn't believe all the 'wires' in there when he showed me the pics, it was very exciting!!! Sorry, I'm a bit of a geek!
Posted 7/9/2013 1:42 PM (GMT 0)
My GI said low resolution MRIs are ok.
Posted 7/9/2013 1:57 PM (GMT 0)
Hi Teacherman,

I wonder how often the high resolution MRI would better reveal important information, vs the low resolution version.  Here are a couple of links with opinions on this:

http://www.ajronline.org/doi/full/10.2214/ajr.181.5.1811211

http://www.diagnosticimaging.com/dimag/legacy/advancedMR/3tmri.html

You may never need a high resolution MRI, but if you do, it might be a matter of life or death, or even just a better outcome.  I know that many implanted devices preclude its use (pacemakers, etc.), but since there are other alternatives, I'd err on the side of having the high resolution available for use just in case it is required.

You're asking for opinions...

Good luck!

Denise

Posted 7/9/2013 3:28 PM (GMT 0)
I agree with you. Thus I haven't had the LInx and will wait. The odds are in my favor. I have a 0.16 chance of getting EC from Barrett's in 16 years. That is very very very low odds. I have to come to grips with my anxiety and move on with life.
I've read some on health related anxiety and know I make my situation worse. Yesterday, I had a small throat thing and noticed how all the muscles in my face, neck and jaw changed as I worried about it. Then I made myself believe it was nothing. Like I would do in the past before all this GERD/ Barrett's stuff happened. What I noticed was all my muscles in my face, jaw and neck completely changed with this thought. Two different thoughts and two very very different muscle reactions. A complete reversal of the way the sit and relax or not. Just with a thought.......or anxiety response thought.
Posted 7/9/2013 3:53 PM (GMT 0)
Hi Teacherman,

I came across some great resources to help deal with health anxiety.  Here's the link to the Resources section; https://www.healingwell.com/community/default.aspx?f=45&m=52985

If you scroll down to the bottom, I've listed links (a few are live...the others refused to be) for a series of health anxiety modules that you can read and work through.  I think you might find them helpful if you're in the mood to deal with the issue.

Health anxiety can be all consuming, I know. I've had plenty of experience with it.  Check out the modules and see what you think.

Good luck!

Denise

PS...I'm a retired second grade teacherwoman!

Posted 7/9/2013 10:39 PM (GMT 0)
Mollymarie

Wow, I didn't have any metal type sutures with any of my nissens....I feel like I got robbed, LOL!


As for why the Nissen vs Linx, it's still the Gold Standard as Denise said. Been around a long time and it works.

Take care,
Bill
Posted 7/10/2013 12:59 AM (GMT 0)
Hi Molliemarie,

If you have metal stitches/clips they will be nonmagnetic, unlike the LINX.  We all learned about different types of metal when we experimented with magnets at school.  The LINX, of course, has magnetic metal.  Any clips they may have used or left in you would certainly be nonmagnetic if they are metal.

Here's a link to some information that should allay your concerns.

http://www.mrisafety.com/safety_article.asp?subject=34

Take care,

Denise

Posted 7/10/2013 4:04 PM (GMT 0)
I would love to have the LINX, however, some people are not considered candidates for that surgery. For example, a hiatal hernia (which I have) excludes me from LINX surgery. And as others have suggested, insurance companies are reluctant to pay for a procedure where no long-term studies exist to support its efficacy. The Nissen has the longest and best track record. I'm having my surgery next month.
Posted 7/10/2013 4:15 PM (GMT 0)
Speaking of HHs, none of the tests I had showed up a HH but when he went in to operate the hernia was massive. How would a LINX surgeon get round this?
Posted 7/10/2013 4:17 PM (GMT 0)
Ha ha! Bill, you missed out there! Demand a refund smilewinkgrin
Posted 7/10/2013 7:49 PM (GMT 0)
Thank you for your input. This is a very difficult choice. Have the surgery? Then what surgery? could I be over anxious? Should i just wait as the odds are in my favor? could aurgery bring more anxious thoughts? I just don't have the answer? But thank you for your input.
Posted 7/10/2013 10:14 PM (GMT 0)
Mollymarie,

My hiatal hernia showed 3 cm on the tests which is right at the limit. When I went in for linx my surgeon found a 6 cm hernia. He called it an ambush hernia. He repaired the hernia and still implanted the linx. I asked him why 3 cm is considered the limit and what the implications were for me. He said they have a 3 cm limit because they sold it to the FDA as an augmentation device as opposed to a replacement for the LES. I guess that means larger hiatal hernias can render the LES useless (which explains all of the trouble I had). My surgeon's take on it is that the linx adds 15 mm/hg of pressure to the LES which puts even a useless LES into the normal range. He also said there was no way he was going to do a nissen on me when I came in for the linx. That would have been the real ambush (and probably a lawsuit).
Posted 7/11/2013 1:18 AM (GMT 0)
Teacherman,

I would say this...the only reason (in my opinion) for having a Nissen or even a LINX is for an improvement of your quality of life.  Check out the posts by Acidrefluxman, who has spoken to multiple experts and done quite a bit of research regarding the risk of cancer with GERD.  According to his research, it sounds as if it's minimal as a factor. 

People who are suffering with enough reflux symptoms to cause them lots of problems--whether it's sleep deprivation or inability to live an active life (or other health issues caused by reflux, like lung involvement)--should go for the surgery for sure.  Only you know if your issues are bad enough to warrant the surgery.  Mine did, and I'm thrilled with the results.  I live a totally normal and much healthier life post-Nissen.

Good luck with your dilemma!

Denise

✚ New Topic ✚ Reply