Went with the Torax LINX

Are you a resident of the US?

Hi Edopter - Great news!

I do have some specific questions:
- How will the follow-ups / any emergency situations be handled in your case? Do you also have a local surgeon here who can work with those in Italy to get you the care you might need?
- Do the surgeons in Italy have recent stats on the success of this procedure now?
- Did you shop between UK and Italy? Was Italy cheaper?
- Did you consider TIF at all?

Thanks Edopter .. please do continue to post your experiences with LINX, as it'll help the rest of us tremendously who are waiting to see if this is something we can give a shot!

I thought the procedure was not available to this in the US. How did you get this work around?

Hi Skitt,

I thought the LINX was not available to those in the US as it is not FDA approved? Can you shed some light on this.

I met with my surgeon for Nissen and plan to do it maybe as fast as two weeks but I would rather have the LINX done if that is the case. I've maxed out my insurance for HMSA so basically my nissen procedure would be free which is good news but I still would rather have the LINX procedure done as it is reversable and seems like the better approach. I have an excellent surgeon here on Hawaii. I have stomach pains from gastritis and LPR sympoms which worry me about Nissen but my surgeon assured me he could have those fixed. That are your throughts.

Thanks.

maximus

Hi Maximus808

The LINX is not approved in the US. I went to Italy and yes it was quite expensive, I will be paying for this for quite a while. Time will tell if this was worth it or not.

My symptoms were not LPR, just basic heartburn on a nearly daily basis even at 60MG Dexilant- which was by far the best PPI for me followed by Zegerid

The Nissen is the gold standard option for GERD with a solid success rate of 90-95% success for typical GERD and 70-80% for less typical GERD http://www.umm.edu/general_surgery/nissen_fundo.htm

Best Wishes for you

Hi Edopter,

Did you need to have a manometry test to qualify for the Linx procedure? Did they say if there is a cutoff manometry score you need to meet for the Linx to be successful?

Did you set off any airport metal detectors on the way home? Just kidding, I hope your recovery is going well. Please let us all know how things progress for you in the next few months. A lot of people are interested in the Linx and the medical tourism approach is a nice option to consider.

Edopter,

I am very interested in traveling abroad to get this procedure done. Can you please provide the steps you took to do so. Who were contacts, flight arrangements, etc. Thank you so much.

Hi Maximus808

I contacted several implantation centers on this list: http://www.toraxmedical.com/linx/implantingCenters.php I ended up selecting the Italy center as they have done the most implantations, however the UK one also was wiling to talk. The above URL has email contact information. They will need your medical records to make an assessment to see if you are a candidate. Just get a copy from your doctor and email them in. I am not sure if there is an FDA issue with Americans going abroad, there certainly isn't an issue for Europeans or Canadians (or anyone else) to come to the US for procedures. Further, it is now a trend for Americans to go abroad (india, mexico, cuba...) for a whole host of surgeries mainly due to cost

Hi Speden,

Yes, I needed to provide the same tests necessary for a Nissen: Manometry, Bravo study, recent scope, and Barium swallow. I did the Barium swallow test in pre-op in Italy. Plus all my medical records regarding GERD.

No I didn't set off the alarm, but you do get a card to carry explaining the implant in case you do.

As for recovery, it has been 12 days since the LINX implant. I am eating carefully, generally softer foods, and chewing everything up well. I am down to 20MG Prilosec one time per day. And I have been eating spicy foods with no problems. The challenging foods are the breads, but if i dip them in the soup and chew completely, i can eat them just fine too.

I feel great. However, I am expecting things to get worse around the two week mark as this is when the body builds a fiberous encasement around the LINX and some dysphasia may occur for a few weeks.

So your US insurance didn't cover any cost of the procedure?

Edopter,

If you don't mind me asking, can I have your email address?

I am really considering flying overseas to get the procedure done.

I already contacted Dr. Bonavina and he said he would do it but would need my medical records.

Did you have a travel agent who helped you book your flights, hotel, etc.

I'm pretty positive, I'm a good candidate for this procedure as I am for Nissen. The cost will be much more but I believe in the long run it will be worth it.

You help is greatly appreciated. Thank you.

Maximus

Hi Maximus808

Your questions and answers:

1. Are you satisfied with the procedure?
-At the moment I am very happy with the procedure. However, it is early not 2 weeks yet so my opinion should be couched with my limited experience.

2. Were you considering Nissen?
-Yes, I had interviewed five surgeons and found the one that was highly recommended and is doing around 100 per year. He uses the da vinci robot for his Nissens. I was at his office planning the surgery for two weeks out when a comment he made about lifestyle change made me want to double down on seeing how I could get the LINX installed. I went back to my GI doc with my concerns and discussed all my options one more time. He was great. I had the thought of going to Europe... buy he actually suggested it. "You could go to Europe if you were willing to pay for it yourself." Then I decided to see if I could make it happen.

3. Did you GI or surgeon recommend the LINX?
-Yes, but only after I brought it up. I have been following the LINX for quite a while. Once I brought it up he reviewed my records and let me know I would be a great candidate for the Nissen or the LINX. We also discussed the Stretta procedure as this is available in the US too. -just not covered by insurance.

4. I thought you could return to a regular diet after the LINX? This is not so?
- eventually yes, but like the Nissen you need to let your body heal. The recommendation is 40 days of soft food. But I was also told to exercise the devise by eating thicker foods if possible. I was also given the instructions of what to do if something gets stuck. Relax, Breath deeply and have a sip of water. It works. I have eaten nuts, pancakes, soft noodles, eggs, chips, soups, bread-dipped in soup, chicken, corn beef hash, and sausages with no problem as long as I chew them up well but I am only at day 13.

5. Any pains or spasms to the esophogus
- Yes pains but just healing pains no big deal. I was on pain killers Acetaminophen 1000Mg twice a day for two days post op

6. Did you need to do a consultation first with the surgeons in Italy before the procedure?
- Since this is remote this step is truncated a bit. I gave him my medical records and after he reviewed them he emailed me I was a candidate. That was enough for me. I also checked in the day before the procedure for the pre-op physical and barium swallow

7. Did you have trouble with the language barrier or could they speak english as well?
- yes a little, but they can speak English pretty well

8 I wish the US did this procedure but I'm banking on the fact that maybe Italy might be the place to get it done.
- yes Italy has done the most installs. I was the 86th

9. Also, how was the pain level post operative and did you need to do any prep before the surgery.
- besides coming in a day before having not eaten for 12 hours there was no prep. Just out of surgery my throat hurt from the scope, my stomach hurt from the incisions, and my left shoulder was killing me from the CO2 they pump into your body as part of Laparoscopic surgery. By the end of the day my throat was fine. My shoulder and stomach were tolerable without pain killers by day 2 after surgery. As other posters of laproscopic surgery (Nissen or ) on this forum have said, the shoulder was the most painful part.

Post Edited (edopter) : 12/6/2011 9:18:50 AM (GMT-7)

Maximus808

Discuss this with your local GI doctor. If you need to remove the LINX it is a simple operation; the surgeon cuts the cable and pull it out. Talking to Prof Dr Bonavina he only did this one time for someone that needed and MRI. So once out of 86 puts your chances pretty low of needing it. There are surgeons in the US that have installed the LINX in San Diego, Mpls, Mayo, and probably a few other places. If you have a problem they will probably be available. As for insurance coverages for problems...I don't know.

The other thing to think about is the LINX is going for FDA review this Jan. So in one to two years it will be available here. At that point you will have more resources for issues if they occur.

Good luck on your surgery. This is exactly why I posted here. I wanted to give forum readers another option to deal with this horrible disease!