Magnetic sphincter augmentation therapy for GERD

Laparoscopic magnetic sphincter augmentation implantation is a safe, well-tolerated, and effective treatment for gastroesophageal reflux disease, reducing medication dependency and improving oesophagal health in clinical practice.

This prospective cohort study assessed how safe and effective a domestically manufactured magnetic sphincter augmentation (MSA) device is for gastroesophageal reflux disease (GERD).

Patients who had typical heartburn and reflux symptoms that were at least partially relieved by proton pump inhibitors were recruited.

Eligible participants exhibited abnormal oesophagal acid exposure and normal oesophagal peristalsis. Excluded were patients with hiatal hernia >2 cm and severe esophagus inflammation. The study involved laparoscopic implantation of the MSA device following the repair of the oesophagal hiatus.  Symptom relief, complications, discontinuation of proton pump inhibitors and surgical satisfaction were assessed with the help of a questionnaire. Gastroscopy, oesophagal pressure measurement, and pH impedance testing were evaluated.

The study successfully implanted the MSA device in all 23 patients, including 20 males and 3 females, with a mean age of 48 years. Postoperatively, significant improvements were noted, these are:

• Subjective relief of total digestive symptoms: 90%
• Subjective relief of total respiratory symptoms: 100%
• Rates of satisfaction: 83%
• Proton pump inhibitor discontinuation rate: 70%
• Proportion of esophagitis decreased from 44% to 9%
• Improvement in Hill grade of gastroesophageal valve morphology from preoperative measurements (1 case of grade I; 5 cases of grade II; 10 cases of grade III; 7 cases of grade IV) to postoperative measurements (22 cases of grade I; 1 case of grade II; 0 cases of grade III and IV).
• Percentage of lower esophageal sphincter pressure below normal declined from 70% to 35%
• 21 patients attained normal esophageal acid exposure after the operation

In terms of adverse events, mild long-term dysphagia was reported in 11 patients but did not affect daily life. No device migration, erosion, or need for secondary surgical removal was observed.

The laparoscopic implantation of the MSA device found to be safe and well tolerated, effectively controlling symptoms of GERD.