What Is the LINX Procedure to Treat Gastroesophageal Reflux Disease (GERD)?

The LINX procedure is a minimally invasive surgery that involves placing a band of magnetic titanium beads around your lower esophagus.

There are several benefits for people living with GERD:

• The surgery is less invasive and has a quicker recovery time than traditional GERD surgery.
• It can be easily reversed if necessary.
• You can usually go home the same day or the next day after your surgery.
• The surgery can potentially reduce symptoms of GERD, such as heartburn and burping.
• It can also potentially reduce the need for medications.

Success rates for the LINX procedure tend to be high. Research has found symptom relief in more than 90% of people lasting at least 10 years.

In a 2020 study, researchers followed a group of 335 people who received the LINX procedure for a period of 6–12 years. The researchers found that proton pump inhibitors (a standard treatment) were discontinued in 79% of people, and 89% of people achieved normalization of their esophageal pH.

How long does the LINX system last?

The LINX system can potentially last a lifetime. But some people need to get their devices removed early. The company reports revision rates ranging from 2.2–12%.

In a 2021 study, researchers found the risk of device removal over a 7-year period was 4.81%.

Initial LINX devices weren’t MRI-compatible, but newer devices now have MRI capability up to at least 1.5 Tesla. This means that people with newer devices can undergo MRI scans without needing to remove the device or replace it if the MRI strength is no more than 1.5 Tesla.

The LINX procedure isn’t always successful. The most common reasons why the LINX device has to be removed include:

• trouble swallowing
• pain when swallowing
• persistent GERD
• device erosion, where the implanted ring may embed in surrounding tissue, causing discomfort
• abdominal pain
• manufacturing issues that affect the device’s performance, durability, or safety
• need for an MRI in older devices
• vomiting
• device migration on the esophagus

Rarely, paralysis of the stomach may occur. This is a condition where the stomach muscle movement is impaired, leading to symptoms like bloating and delayed emptying.

More research is needed to understand the long-term safety of the LINX device in people who are immunosuppressed.

Here’s what you can expect before, during, and after the LINX procedure.

Before the procedure

You’ll receive general anesthesia through an IV before your procedure. It’s usually administered through a vein in your hand or wrist.

During the procedure

During the LINX procedure:

1. Your surgeon will access your esophagus by making several small incisions in your abdomen.
2. They will then insert a band made up of a ring of magnetic beads around the base of your esophagus.
3. Your surgeon will close the incisions with absorbable stitches and cover them with dressing.

The whole procedure may take less than an hour.

After the procedure

You’ll likely be able to go home the same day as your procedure, but in some cases, you may need to stay overnight. You’ll likely be able to eat normally on the same day as your surgery.

You’ll undergo evaluation before your procedure that will likely include tests like:

• esophageal pH test
• endoscopy
• esophageal motility testing
• barium swallow

Your surgeon will give you specific instructions on preparing for your procedure. They may tell you that you need to avoid smoking for several weeks.

You’ll usually need to stop eating at least 6 hours before your procedure and stop drinking at least 2 hours before. Follow the exact instructions your surgery team provides.

Usually, it’s recommended that you start by eating semi-soft foods like yogurt and crackers every 1–2 hours while awake to help the device expand.

You may have trouble swallowing starting 10–14 days after your procedure.

The cost of the LINX device itself averages about $5,000, but hospital and surgery expenses can be another $10,000. In a 2020 review of research, researchers found the average insurance reimbursement for LINX surgery was $13,522.

Medicare currently doesn’t cover the LINX procedure, but private insurance companies may offer coverage in some cases.

The LINX procedure is intended to be used in adults who don’t respond to medications like proton pump inhibitors and who are candidates for traditional GERD surgery.

People with obesity may not be candidates since obesity may interfere with the outcomes.

Other treatments for GERD include lifestyle changes like:

• losing weight if needed
• quitting smoking if you currently smoke
• limiting alcohol and spicy foods
• sleeping with your head elevated

Common medications include:

• antacids
• proton pump inhibitors
• H2 blockers

Your doctor may also recommend fundoplication. This procedure involves tightening the sphincter that separates your esophagus and stomach.

The LINX procedure is a minimally invasive surgery that can potentially reduce symptoms of GERD. It involves placing a magnetic band around your lower esophagus to reduce the backup of stomach acid.

Research suggests that the LINX procedure has high rates of success and low rates of complications. Your doctor may recommend the LINX procedure if medications and lifestyle changes don’t relieve your symptoms.