Bortolotti M. Magnetic challenge against gastroesophageal reflux . World J Gastroenterol 2021; 27(48): 8227-8241 [PMID: 35068867 DOI: 10.3748/wjg.v27.i48.8227]
Corresponding Author of This Article
Mauro Bortolotti, MD, Via Massarenti 48, Bologna 40138, Italy. bormau@tin.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Frontier
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 28, 2021; 27(48): 8227-8241 Published online Dec 28, 2021. doi: 10.3748/wjg.v27.i48.8227
Magnetic challenge against gastroesophageal reflux
Mauro Bortolotti
Mauro Bortolotti, Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Polyclinic, University of Bologna, Bologna 40138, Italy
Mauro Bortolotti, Via Massarenti 48, Bologna 40138, Italy
Author contributions: Bortolotti M drafted the manuscript and revised the manuscript.
Conflict-of-interest statement: The author declares no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Received: May 27, 2021 Peer-review started: May 27, 2021 First decision: June 21, 2021 Revised: July 7, 2021 Accepted: December 3, 2021 Article in press: December 3, 2021 Published online: December 28, 2021 Processing time: 210 Days and 17.5 Hours
Abstract
Almost 15 years have passed since the first paper on the possibility of using magnets to prevent gastro-esophageal reflux (GER) was published and so it is time to assess the results obtained with the first magnetic device available on the market, the Linx magnetic sphincter augmentation (MSA) and to consider what other options are forthcoming. MSA demonstrated an anti-reflux activity similar to that of Nissen fundoplication, considered the “gold standard” surgical treatment for GER disease, and caused less gas-bloating and a better ability to allow vomiting and belching. However, unlike Nissen fundoplication, this magnetic device is burdened by complications, which are roughly similar to those of the non-magnetic anti-reflux Angelchik prosthesis, that, after considerable use in the eighties, was shelved due to these complications. It is interesting to note that some of these complications show the same pathophysiological mechanism in both devices. The upcoming new magnetic devices should avoid these complications, as their anti-reflux magnetic mechanism is completely different. The experiments in animals regarding these new magnetic appliances were examined, remarking their advantages and drawbacks, but the way to apply them in surgical practice is long and difficult, although worthy, as they represent the future of magnetic surgery.
Core Tip: The idea of a magnetic device aimed to prevent gastroesophageal reflux was conceived and realized more or less 15 years ago, for which it is time to take stock and consider its future. The first and only device available nowadays in the market is the Linx magnetic sphincter augmentation. Its effectiveness was examined and compared to that of Nissen fundoplication, whereas its complications, similar to those of the Angelchik prosthesis, were described and their pathophysiology discussed. Furthermore, the pros and cons of the upcoming magnetic anti-reflux devices were examined, underlining the fact that, working with a mechanism completely different to that of the first device, many of its complications could be avoided.
