Magnetic implants for GERD management

According to the National Institute of Diabetes and Digestive and Kidney Diseases, around 20 percent of people in the United States have gastroesophageal reflux disease (GERD). GERD is when stomach acid repeatedly flows up the esophagus causing recurrent symptoms and can cause complications over time. GERD can often be treated with lifestyle modifications and medications.

If lifestyle modifications and daily medications don’t control your GERD symptoms, there are other options. Clifford Smith, MD, is a board-certified and fellowship-trained general surgeon with Richmond Surgical who specializes in treating patients with GERD and spearheads the Heartburn and Reflux Center of Richmond at Henrico Doctors’ Hospital. He is an expert in minimally invasive procedures to treat GERD, including a laparoscopic procedure in which a magnetic sphincter implant can help manage the condition. Dr. Smith and the team of gastrointestinal specialists at the Heartburn and Reflux Center of Richmond performed the first magnetic sphincter augmentation in the region and continue their work to ensure that reflux no longer controls patients’ lives.

What is magnetic sphincter augmentation?

If you suffer from GERD, your lower esophageal sphincter is shorter or weaker and relaxes more easily than others. This allows undigested food, acid, and bile to regurgitate back into your esophagus, resulting in heartburn, coughing, asthma, bloating, throat clearing, and other symptoms. Magnetic sphincter augmentation is an innovative technology designed to strengthen the barrier between the stomach and lower esophagus.

How is the procedure performed?

Magnetic sphincter augmentation is performed as an outpatient procedure that takes about an hour. Using a minimally invasive laparoscopic approach, patients are placed under general anesthesia and tiny incisions are made in the abdominal wall to access the esophagus. A small, flexible ring is then positioned around the lower end of the esophagus, just above the stomach. The ring is made of a series of interlinked titanium beads with magnetic cores. The magnetic attraction between the beads opens when you swallow and then closes the lower esophageal sphincter to prevent reflux. Prior to the procedure, patients undergo motility testing to ensure their esophagus has the strength to force open the magnetic beads when swallowing.

The titanium design is intended to last a lifetime without the need for future revision surgery. In addition to strengthening the esophageal sphincter to stop reflux, the magnets also preserve normal functions like belching and vomiting, sometimes a concern for other types of anti-reflux operations.

Patients typically return home the same day or the next day, and resume a normal diet within 48 hours—significantly faster than traditional fundoplication surgery. While the magnetic augmentation surgery is reversible, long-term success rates are extremely high, and the device rarely needs to be removed or revised.

Benefits of magnetic sphincter augmentation

Several long-term studies published by the National Institutes of Health promote the benefits of magnetic sphincter implantation, including an overall improvement in patient quality of life. Other payoffs often include:

• Almost 100% of patients report no regurgitation five years post-surgery
• Over 85% of patients have no major heartburn symptoms after five years
• 85% of patients no longer need a proton pump inhibitor or daily heartburn medication
• More than 80% of patients have reported a 50% reduction in their heartburn symptoms
• Less invasive and more easily reversible than fundoplication surgery

Potential side effects

As with any procedure, it’s possible that side effects may occur. With this treatment, side effects are typically minimal. Some patients report some pain and difficulty in swallowing after surgery, but these symptoms usually subside over the first several weeks.

Candidates for magnetic sphincter augmentation

Unfortunately, some patients are not eligible for the procedure, specifically those who have had prior anti-reflux surgery or those with:

• A pacemaker
• An allergy to titanium

Magnetic sphincter augmentation is a safe procedure that is tolerated well by most patients. Patients should consider it as a procedure with minimal side effects and a faster recovery time than other anti-reflux surgeries.