Updates in Surgery

, Volume 70, Issue 3, pp 323–330 | Cite as

Magnetic sphincter augmentation for gastroesophageal reflux disease: review of clinical studies

  • Emanuele Asti
  • Alberto Aiolfi
  • Veronica Lazzari
  • Andrea Sironi
  • Matteo Porta
  • Luigi BonavinaEmail author
Review Article


Use of the magnetic sphincter augmentation (MSA) device for the laparoscopic treatment of gastroesophageal reflux disease is increasing since the first clinical implant performed a decade ago. The MSA procedure is a minimally invasive and highly standardized surgical option for patients who are partially responders to proton-pump inhibitors, which have troublesome regurgitation or develop progressive symptoms despite continuous medical therapy. The procedure has proven to be highly effective in improving typical reflux symptoms, reducing the use of proton-pump inhibitors, and decreasing esophageal acid exposure. Observational cohort studies have shown that MSA compares well with fundoplication in selected patients and has an acceptable safety profile. The device can be easily removed if necessary, thereby preserving the option of fundoplication in the future. The majority of the removals have occurred within 2 years after implant and have been managed non-emergently, with no complications or long-term consequences. “Expanded” indications to MSA (large hiatal hernia and Barrett’s esophagus) need to be tested in further comparative studies with classic fundoplication procedures.


Gastroesophageal reflux disease Lower esophageal sphincter Fundoplication Hiatus hernia Magnetic sphincter augmentation Linx 



No funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants 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.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Division of General Surgery, Department of Biomedical Sciences for Health, IRCCS Policlinico San DonatoUniversity of MilanoMilanItaly
  2. 2.Divisione Universitaria di ChirurgiaIRCCS Policlinico San DonatoMilanItaly

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