[Silicone anti-reflux prosthesis--an artificial fundoplication?]

Of all anti-reflux operations fundoplication has proved the most effective method in experimental and clinical examinations [3, 5, 9, 12, 13]. In 1979 Angelchik reported a silicon prosthesis as an anti-reflux barrier which proved effective in examinations on patients. An explanation for these results is still missing [1]. Our examinations in dogs show that: 1. anti-reflux prosthesis is an effective anti-reflux barrier in dogs after circular myectomy; 2. silicon prosthesis proved to be equally as effective as fundoplication with regard to reflux prevention; 3. the mechanism of action is a mechanical one. The difference between silicon prosthesis and fundoplication is, that the fundoplication represents a 'ring' around the LES, which is elastic and is subject to the same regulations as the LES, and that it can relax in a swallowing reflex manner. In the silicon prosthesis the 'ring-formation' is only mechanical.