Magnetic Sphincter Augmentation After Gastric Surgery.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Devices

Background:

• Gastroesophageal reflux disease (GERD) can persist or develop after gastric/bariatric surgery.
• Magnetic sphincter augmentation (MSA) is explored as a treatment for GERD in this patient population.

Purpose of the Study:

• To investigate the efficacy of MSA in managing GERD following prior gastric or bariatric procedures.
• To evaluate the safety and outcomes of MSA in patients with refractory GERD post-surgery.

Main Methods:

• A systematic review was conducted following PRISMA guidelines, searching multiple databases up to May 2019.
• A local institutional cohort of patients undergoing MSA was analyzed, comparing those with prior gastric surgery to naïve patients.

Main Results:

• Seven studies with 35 patients showed significant improvement in GERD-HRQL scores post-MSA (P = .005).
• Two patients (5.7%) required device removal; prior surgery patients had longer operative times and hospital stays.
• MSA demonstrated feasibility in treating refractory GERD after bariatric procedures like sleeve gastrectomy or Roux-en-Y gastric bypass.

Conclusions:

• Magnetic sphincter augmentation (MSA) is a safe, simple, and standardized option for antireflux treatment.
• MSA is a feasible solution for refractory GERD in patients who have undergone gastric/bariatric surgery.
• Further prospective, comparative studies are necessary to confirm these findings.