Advice after your nerve block for surgery
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What is the LINX Reflux Management System?
The LINX Reflux Management System is a medical device for patients who are having surgery to treat Gastroesophageal Reflux Disease (GORD).
GORD occurs when the sphincter (valve) between the stomach and oesophagus (food pipe) is weak or opens abnormally. Stomach juices reflux into the food pipe causing symptoms of heartburn or regurgitation.
The LINX System is designed to help the sphincter stay closed to stop the reflux. It uses a small, flexible band of beads. Each bead has a magnet inside. When placed around the outside of the oesophagus, the magnetic attraction between the beads helps the sphincter stay closed to prevent reflux. Swallowing food will overcome the magnetic attraction and allow the beads to separate, allowing food and liquid to pass normally into the stomach.
Contraindications
Patients with suspected or known allergies to titanium, stainless steel, nickel, or ferrous materials should never be implanted with the LINX System. If you have an allergy to titanium, stainless steel, nickel or ferrous materials, tell your doctor. Please note, Nickel is not a metal component of the LINX device, only the LINX Sizing Tool contains Nickel.
Warnings: Things you must do to avoid serious harm
- The LINX System is considered MR Conditional in a magnetic resonance imaging (MRI) system up to 1.5‐Tesla (1.5 T). Scanning under different conditions may result in serious injury to you and/or interfere with the magnetic strength and the function of the device. If a doctor prescribes an MRI examination for you, inform the doctor and MRI technologists that you have an implanted device prior to your MRI examination appointment.
- It is recommended that anyone implanted with the LINX System register the device with the Medic Alert Foundation (www.
medicalert.org ) or a similar organization.
Possible risks of having this done
The most common complications related to the LINX device and/or procedure were:
- Dysphagia (difficulty swallowing)
- Pain (chest and upper abdominal)
- Stomach bloating
Serious or frequently occurring risks:
- Infection including that of the lung, blood, abdomen and urine
- Deep vein thrombosis and pulmonary embolism
- Bleeding requiring a transfusion or emergency surgery
- Injury to blood vessels, nerves, abdominal organs or the lining of the lung (pleura)
- Delayed perforation after surgery is a serious complication which can lead to further surgery, a prolonged hospital stay, admission to intensive care, invasive lines and drains.
- Drain insertion into the abdomen or the chest
- Early difficulty in swallowing (weeks 2 to 12)
- Prolonged difficulty swallowing 15% – difficulty swallowing normal foods that does not improve within 6 months of surgery may need further investigation and treatment.
- Incomplete control of reflux or recurrence of reflux – this is usually treated with anti-reflux medication and in some cases revisional surgery.
- LINX device erosion (1:1000) this is a serious complication which requires further surgery
- Linx device failure or moving away from original position (slippage) – can cause difficulty swallowing or reflux recurrence.
- Gas-Bloating or irritable bowel symptoms including diarrhoea
- Hernia near one of the cuts (port site hernia)
- Death – any surgery or invasive procedure carries a risk of death. The risk varies from 1:1000 to 1:100 depending on an individual’s health.
Possible benefits of having this done
Benefits of treatment with the LINX System may include:
- Recommended by NICE as a safe alternative to fundoplication in treating GORD
- Ability to resume a normal diet following surgery
- Discharge the same day or the next day after surgery
How to decide about this treatment
When considering the LINX System, it is important to understand the following:
- The device is a permanent implant, and limited long‐term experience is available.
- Every patient is different. There are no guarantees that your GORD symptoms will improve. It is possible you may need to continue GORD medications after treatment.
- The LINX System is only considered safe for magnetic resonance imaging (MRI) in MRI scanning machines up to 1.5 T (magnetic field strength). You should discuss the MRI scanning options with your doctor prior to deciding on treatment with the LINX System.
- The LINX System has not been studied in patients with Barrett's oesophagus, advanced esophagitis (inflammation of the oesophagus), prior gastric surgeries with the exception of laparoscopic sleeve gastrectomy (LSG), metallic implants such pacemakers or defibrillators, swallowing difficulties, or motility disorders. Please discuss your medical history with your doctor to determine if you have any conditions for which the LINX System is not recommended.
- The LINX System is not the only option available. The standard surgical treatment for GORD is a fundoplication.
- Other treatments performed around lower oesophagus may not be possible or will need careful consideration if the LINX System is present. These treatments may include surgical or endoscopic interventions for weight loss, Barrett’s oesophagus or GORD.
What happens before the treatment?
You will need to have several tests to make sure you are healthy enough for the surgery and to
assess your oesophagus. Your doctor will explain these tests to you.
These tests will likely include:
- Oesophageal pH testing (tests for acid in the oesophagus)
- Manometry/Motility (measures pressures in the oesophagus and how many swallows are effective)
- Endoscopy (a visual examination of your oesophagus using an endoscope)
- Barium eosophagram (x‐ray to examine the oesophagus. The x‐ray is performed while you drink chalky substance called contrast.)
What happens during the treatment?
Under general anaesthesia, a surgeon who has experience in anti‐reflux procedures and has received specific training in the use of the LINX device, will access the oesophagus using a keyhole approach. The LINX System is placed around the oesophagus and the ends of the device are attached to each other. The procedure usually takes less than one hour to perform. It is unlikely that the LINX System will move from the place where it was implanted since it becomes encapsulated (covered) with tissue during the healing process.
What happens after the treatment?
Return to normal diet
You should return to a normal diet within 48 hours, as soon as tolerated after the surgery. This is important to ensure proper healing at the implant site of the LINX System.
You may have difficulty swallowing
You may feel like you are having difficulty or pain with swallowing after the surgery. This is normal and expected. If you have trouble swallowing, follow these steps:
- Drink a few sips of water before taking your first bite of food and between bites as necessary.
- Take small bites of foods that can easily pass down your oesophagus and into your stomach.
- Chew food well before swallowing.
- Foods like bread, pasta, rice, and meat are more likely to cause problems.
Implant Card
You will receive a LINX Implant Card following your surgery. Carry your LINX Implant Card with you as notification to care providers that you have received a LINX System. If you lose this card, please contact your doctor’s office.
MRI
If you are told that you need to have an MRI procedure you must notify the physician requesting the MRI or MRI personnel that you have been implanted with the LINX system, which is only safe to undergo scanning under certain conditions. Undergoing an MRI scan in a machine greater than 1.5 T could cause serious injury to you and/or interfere with the magnetic strength and the function of the device.
Other surgical or endoscopic treatments
If you are told you need other surgical procedures or endoscopic treatments of your oesophagus you must let the team looking after you for these procedures that you have a LINX device. These may be contraindicated because of the presence of the LINX System.
Travel
You may travel as soon as advised by your doctor. The LINX System should not interfere with airport security. You should carry your implant card when traveling so others will know you have an implanted device in case of an emergency.
I heard surgery might be done with the robot; what is the difference?
Your surgeon may perform your surgery robotically; this is a different key hole surgery approach and has no bearing on outcome.
If you are experiencing any of the following symptoms, please contact your surgical team
- Unable to eat or drink.
- Severe pain
- Fever
- Feeling unwell
- Wound problems
Contact Information
If your operation was at Wexham Park Hospital
- 07468 354436 available Monday to Friday 9am to 5pm
- 07826 921319 available 10pm to 7am
If your operation was at Frimley Park Hospital
- 07990 528061 available 24 hours
If you cannot get in contact, please call 111
If you feel seriously unwell, call 999 or go to the nearest Emergency Department
Contact us
If you have any queries relating to this information, please contact the General surgery service.
About this information
Service:
General surgery
Reference:
Y/008
Approval date:
2 January 2025
Review date:
2 January 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.