What is the LINX procedure?

Magnetic lower esophageal sphincter augmentation, also called the LINX procedure, is a minimally invasive treatment for chronic acid reflux.

It works by strengthening the muscle at the bottom of your esophagus called the lower esophageal sphincter (LES). The LES typically opens to allow food to empty into your stomach and closes to prevent acid from flowing backward into your esophagus.

The LINX procedure involves placing a ring of tiny magnetic beads made of titanium around the LES to reinforce it and help keep it closed. The magnets are weak enough to allow food to pass into your stomach but strong enough to prevent food and acid from reentering the esophagus and causing heartburn.

doctor discussing the LINX procedure with an older male patient

Why might I need a LINX procedure?

If you experience frequent heartburn as a result of a hiatal hernia, a weakened LES or both, the LINX procedure is an option to manage it. It was designed to be more dynamic than a traditional anti-reflux procedure called a fundoplication. Your care team will usually recommend lifestyle modifications such as weight loss and smaller meals, as well as antacid medications, as treatments first. But if these do not provide relief, a surgeon can discuss if a LINX device is right for you.

How to prepare for a LINX procedure

Once your surgeon determines you are a candidate, you will be asked about any metal allergies, especially to nickel, which is used when implanting the device.

Your care team will carry out an esophageal workup before the procedure, which may include:

  • Barium swallow (esophagogram): You will swallow barium, and a radiologist will take X-rays that show the barium as it moves through your esophagus. The test shows structural issues in your esophagus, motility problems and whether a hernia is present.
  • Esophageal manometry: This test measures the function of your esophagus. The muscles of the esophagus are used in a coordinated motion called peristalsis. The better the peristalsis, the better you are as a candidate for LINX. This test utilizes a catheter that is placed through your nose and passed all the way to your stomach. A series of swallowing commands will show your peristalsis, and then the catheter is removed.
  • pH testing: This quantifies how much acid escapes your stomach into your esophagus. The most common method uses a small capsule placed during an endoscopy. It sends data to a receiver as you go about your daily activities for 4 days. The capsule then passes naturally through your digestive system.
  • Upper GI endoscopy: A camera on the end of an endoscope is inserted into your esophagus while you are under sedation. This gives your healthcare team the option to look at the beginning of the gastrointestinal tract that includes the esophagus, stomach and duodenum (small bowel). It can see any damage to the esophagus from acid, such as strictures and burn marks, as well as a hiatal hernia or other abnormalities.

Who is not a candidate for the LINX procedure?

Your surgeon will consult with you and discuss whether the LINX procedure is a good option for you.

You may not be eligible if you have:

  • A body mass index of 35 or higher
  • An esophageal motility disorder
  • Esophageal cancer
  • An existing reaction to an electrical or metallic implant
  • Gastric cancer
  • Caution with hiatal hernias
  • Narrowing of your esophagus (esophageal stricture)
  • Scleroderma

General considerations for a surgical procedure are also important, such as if you are pregnant, breastfeeding or younger than age 18.

The LINX procedure

The LINX procedure is a minimally invasive surgery. Surgeons do this under general anesthesia through small incisions. The surgery typically takes about 1-2 hours, depending on whether a hiatal hernia needs repair.

Your team will give you specific instructions to follow in the days and hours leading up to your surgery. Follow them closely and have someone available to drive you to and from surgery.

Before the procedure

Your surgeon will see you at the hospital and you will meet your anesthesiologist. The procedure requires general anesthesia, which means you will need a breathing tube during the procedure.

LINX procedure recovery

Recovery from the LINX procedure may take a few weeks or months, but you should be able to return to work (if your job doesn’t involve heavy lifting) and your other usual activities within a few days.

Eating habits are the main factor in your recovery. After surgery, you will be asked to eat more frequently and have smaller meals. For certain people, the inflammation around the device can be more intense, making it difficult to swallow, but this typically resolves itself within a few weeks of surgery. On rare occasions, this can persist beyond a month. Your surgeon will help guide you if this situation arises.

With a repair of a hiatal hernia, your surgeon will likely ask you to refrain from lifting anything heavy. You may feel shoulder pain from irritation in your diaphragm, which can be managed with medication.  

LINX procedure side effects

Side effects of the LINX device are rare. Some people may experience difficulty swallowing after the procedure. In the first few weeks after surgery, this is related to the inflammatory response around the device. It resolves in the majority of people within a month. If it continues, it can be managed with steroid medications. Only on rare occasions does the device need to be removed.

a woman standing outside thinking about LINX procedure side effects

LINX procedure complications

All surgeries carry a risk of complications. Risks include:

  • Breathing or respiratory problems
  • Fever
  • Infection
  • Injury
  • Heart problems
  • Diarrhea
  • Allergic reaction to anesthesia

The LINX device is relatively safe. However, it is an implant, so there can be a very small risk of erosion of the device through the wall of the esophagus.

doctor discussing LINX procedure complications with a patient

Frequently asked questions

Loading...