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Esophageal Magnetic Sphincter Augmentation as a Novel Approach to Post-bariatric Surgery Gastroesophageal Reflux Disease

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Abstract

Background

We sought to evaluate the safety and effectiveness of magnetic sphincter augmentation (MSA) in patients with GERD after bariatric surgery.

Methods

Pre- and post-operative GERD quality of life (G-QOL) surveys were conducted. Standard indications (SI) group or the post-bariatric group (PB) created. Outcomes were compared between groups.

Results

Twenty-eight patients analyzed with no losses to follow-up. All patients had preoperative testing confirming normal motility and presence of GERD. No patients were lost to follow-up. The PB group (N = 10) were mostly prior sleeve gastrectomies (N = 8) with two previous gastric bypasses. PB patients required larger MSA device size (16 beads) compared to the SI group (14 beads, p < 0.001). Outcomes were no different with percent improvement between pre- and post-operative G-QOL survey scores with 70% improvement for PB and 84% for SI (p = 0.13). Medication cessation was possible in 90% for PB versus 94% for SI (p = 0.99). Rates of post-operative dysphagia were similar between the two groups.

Conclusions

Although larger prospective randomized studies are needed, there is an exciting potential for the role of MSA, providing surgeons a new and much needed tool in their armamentarium against refractory or de novo GERD after bariatric procedures.

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Authors and Affiliations

  1. Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Avenue, Tacoma, WA, 98431, USA

    John P. Kuckelman, Cody J. Phillips, Michael J. Derickson & Matthew J. Martin

  2. Department of Surgery, Eisenhower Army Medical Center, Augusta, GA, USA

    Byron J. Faler

Authors
  1. John P. Kuckelman
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  2. Cody J. Phillips
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  3. Michael J. Derickson
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  4. Byron J. Faler
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  5. Matthew J. Martin
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Corresponding author

Correspondence to John P. Kuckelman.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study. This was performed in conjunction with the pre and post-operative surveys performed.

Statement of Human Rights

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kuckelman, J.P., Phillips, C.J., Derickson, M.J. et al. Esophageal Magnetic Sphincter Augmentation as a Novel Approach to Post-bariatric Surgery Gastroesophageal Reflux Disease. OBES SURG 28, 3080–3086 (2018). https://doi.org/10.1007/s11695-018-3292-y

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