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Updated: Jun 10, 2025

Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD
Zhihao Zhu1,2, Jinlei Mao1, Menghui Zhou1
1General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China.
Introduction:
Magnetic sphincter augmentation (MSA) is a novel surgical technique investigated at many clinical institutes worldwide. In 2012, it received approval for treating Gastroesophageal reflux disease (GERD) because of its superior benefits compared to drug therapies. This study aimed to explore the safety and efficacy of MSA compared with Laparoscopic Nissen fundoplication (LNF) for GERD treatment.
Methods:
A retrospective analysis was conducted on 40 patients who received preoperative matching features of MSA and LNF. The surgical details and one-year postoperative outcomes were analyzed and reported.
Results:
Significant improvement in GERD symptoms was observed in both MSA and LNF patients over the one-year surgical follow-up. Dysphagia was a common postoperative complication observed in both procedures, but no cases required endoscopic dilation. MSA had a significantly shorter operative time compared to LNF (112 vs.175 min, P < 0.001), with faster postoperative dietary recovery [1(0.5,1.5) vs. 3(1.63,5.38) month(s), P < 0.001] and more preservation of hiccup ability (87.5% vs. 45.83%, P = 0.01). No significant disparities were observed between the two groups regarding hospital duration, recovery of physical strength, and upper gastrointestinal complaints.
Conclusion:
In conclusion, both LNF and MSA are safe and successful surgical therapies for GERD. The benefits of MSA include reduced surgical time, quicker nutritional recovery following surgery, and preservation of hiccup capacity. However, with both surgeries, postoperative dysphagia is a prevalent problem that emphasizes the significance of improving preoperative communication. When selecting between two surgical techniques, it is crucial to consider the postoperative symptoms associated with each procedure.
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