First NHS hospital offers new implant surgery for GORD sufferers

Royal Exeter and Devon carries out keyhole surgery to fit LINX Reflux Management System

The Royal Devon and Exeter NHS Foundation Trust has become the first NHS hospital in the UK to perform an innovative new surgical procedure for sufferers of gastro oesophageal reflux disease (GORD).

The LINX system involves a band of magnetic interlinked titanium beads

Following in the footsteps of private health providers, the NHS is embracing the LINX Reflux Management System, a revolutionary new treatment for severe and persistent acid reflux manufactured by Torax Medical.

A fifth of adults suffer from some form of acid reflux during their lifetime and for most medication will help to reduce the amount of acid their stomach produces. However, with GORD the valve between the oesophagus and the stomach is incompetent and does not close properly between meals.

Until now, other than medication, the only common surgical approach has been a procedure to tighten the junction between the stomach and the oesophegus, known as fundoplication. This involves gathering the part of the stomach that is closest to the entry of the oesophagus and wrapping and suturing it around the lower end of the oesophagus and the lower oesophageal sphincter. This increases the pressure at the lower end of the oesophagus and thereby reduces acid reflux. But, despite the surgery becoming less invasive over the past few decades, fundoplication does not offer a complete solution and it is linked to quite significant side effects, with patients having difficulty swallowing afterwards as well as being unable to vomit or burp.

Studies have indicated that patients with acid reflux experience impaired health-related quality of life similar to, or even greater than, patients with other chronic diseases, such as diabetes and cancer

In contrast, the LINX system, which has been available for the past 18 months from private healthcare companies in the UK, involves a band of magnetic interlinked titanium beads which allow drink and food to pass through normally, but close immediately after swallowing to restore the body’s natural barrier to the reflux of acid and bile.

The band is placed around the oesophagus just above the stomach during a minimally-invasive procedure lasting just an hour. It works straight away and patients can resume a normal diet within a few hours and return to normal activities in less than a week. Unlike fundoplication, the system also allows belching and vomiting.

The beauty of this simple procedure is that it can be completed in less than an hour and it starts working immediately, offering patients relief from the symptoms of GORD and a quick return to normal life

In clinical trials it was found to significantly reduce levels of acid exposure in the oesophagus for two years after implantation. In addition, 86% of patients completely stopped taking medication following insertion, and 90% had a normal level of acid exposure in the oesophagus. It has since been implanted into 17 UK patients.

The Royal Devon and Exeter Hospital is the first NHS service to offer the procedure and Jones was its first patient.

He said: “The condition was affecting my sleep pattern and I felt unwell, so I was taking time off work.

The sales assistant from Sidbury, east Devon, was initially prescribed medication known as proton pump inhibitors (PPIs) to try and alleviate the symptoms, but said: “None of the medication worked. As a result I had to avoid certain foods and caffeine because they would set off severe heartburn.”

We are delighted to be one of the few centres in the UK selected to offer this exciting new procedure and hope to offer it to more of our patients in the region

The LINX procedure was performed by consultant surgeon, Saj Wajed, a specialist in upper gastrointestinal laparoscopic surgery. He said: “GORD is not only painful, but often disrupts sleep, eating, drinking, relationships and social activities. Studies have indicated that patients with acid reflux experience impaired health-related quality of life similar to, or even greater than, patients with other chronic diseases, such as diabetes and cancer. The beauty of this simple procedure is that it can be completed in less than an hour and it starts working immediately, offering patients relief from the symptoms of GORD and a quick return to normal life.”

Following the procedure, Jones said: “My condition was really starting to spoil my enjoyment of food, so I’m really looking forward to being able to worry less about narrowing down my dietary options. After I eat and drink, I don’t get that uncomfortable heartburn anymore. Importantly, my sleep has also improved and I can enjoy a good night’s rest for the first time in several years”.

Wajed added: “We are delighted to be one of the few centres in the UK selected to offer this exciting new procedure and hope to offer it to more of our patients in the region.”

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