Magnetic sphincter augmentation at the time of bariatric surgery: an analysis of the MBSAQIP

Clapp, Benjamin; Dodoo, Christopher; Harper, Brittany; Kim, Ji-Soo; Castro, Christian; Hamdan, Marah; Grasso, Samuel; Davis, Brian R.

doi:10.1016/j.soard.2020.10.024

Cited by 12 publications

(6 citation statements)

References 25 publications

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“…However, there was a marked heterogeneity in terms of study methodology and use of patient-reported versus objective outcomes, and a few explants have been reported. 11-14…”

Section: Discussionmentioning

confidence: 99%

“…However, there was a marked heterogeneity in terms of study methodology and use of patient-reported versus objective outcomes, and a few explants have been reported. [11][12][13][14] We advocate crural repair in all patients undergoing revisional surgery for GERD after LSG, regardless of the presence of HH. A more extended mediastinal dissection, a longer operative time, and a larger MSA device may be necessary in these patients.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Sphincter Augmentation for Hiatus Hernia and De Novo Gerd after Sleeve Gastrectomy

Asti

Bernardi

Bonavina

2021

Foregut: The Journal of the American Foregut Society

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Laparoscopic sleeve gastrectomy (LSG) has become the most popular bariatric surgical procedure owing to its safety, reproducibility and effectiveness. However, gastroesophageal reflux disease (GERD) with or without hiatal hernia is diagnosed at an alarming rate after LSG. Revisional surgery and conversion to Roux-en-Y gastric bypass (RYGB) does not guarantee total reflux control and is associated with morbidity. Magnetic sphincter augmentation (MSA) combined with crural repair is an alternative therapeutic option as a concurrent or remedial procedure in LSG, but current clinical evidence is still limited.

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“…However, there was a marked heterogeneity in terms of study methodology and use of patient-reported versus objective outcomes, and a few explants have been reported. 11-14…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Magnetic Sphincter Augmentation for Hiatus Hernia and De Novo Gerd after Sleeve Gastrectomy

Asti

Bernardi

Bonavina

2021

Foregut: The Journal of the American Foregut Society

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“…Of note, the rate of preoperative GERD was similar in both patient groups. MSA did not increase complications at 30-days [ 40 ▪ ].…”

Section: Effect Of Magnetic Sphincter Augmentation On Persistent or D...mentioning

confidence: 99%

The role of magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease

Bonavina

Boyle

Schoppmann

2021

Current Opinion in Gastroenterology

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Purpose of reviewMagnetic sphincter augmentation (MSA) has been designed as a less disruptive and more standardized laparoscopic surgical procedure than fundoplication for patients with early stage gastroesophageal reflux disease (GERD). We analyzed the more recent literature in search of updates regarding indications, technique, perioperative management, and long-term outcomes.Recent findingsOver the years, the procedure of MSA has evolved to including full hiatus repair rather than relying on the preservation of the phreno-esophageal ligament. Restoring the mechanical synergy between the lower esophageal sphincter and the crural diaphragm has the potential to further enhance the antireflux barrier. The adoption of this approach has led to expand the indications from early stage disease to different scenarios including patients with high esophageal acid exposure, atypical symptoms, large hiatal hernias, Barrett's esophagus, postbariatric surgery, and previously failed fundoplication.SummaryMSA has a favorable side-effect profile and is highly effective in reducing typical reflux symptoms, medication dependency, and esophageal acid exposure. Excellent outcomes have been confirmed over a 12-year follow-up, indicating that the operation has the potential to prevent GERD progression. Further studies are needed to confirm the cost-effectiveness of this procedure in patients with more advanced disease-stage and prior gastric surgery. A randomized control trial comparing MSA with fundoplication could raise the level of evidence and the strength of recommendation.

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“…30 While a database study found MSA placement at the time of SG to have no difference in morbidity or mortality at 30 day follow up, longer follow up studies are needed to determine efficacy and safety. 31 As most studies have focused on GERD outcomes, understanding the effects of SG on esophageal motility has been limited as studies have focused primarily on manometric factors that influence development of GERD such as LES pressure. Results have been variable with some finding increased LES resting pressure, 32,33 others reporting decreased LES resting pressure 8,11,34,35 and other studies reporting no change to LES resting pressure after SG.…”

Section: Sleeve Gastrectomymentioning

confidence: 99%

Section: Sleeve Gastrectomymentioning

confidence: 99%

Effects of Obesity Surgery on GERD and Esophageal Motility

Nguyen

2021

Foregut: The Journal of the American Foregut Society

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With the rising prevalence of obesity, bariatric surgery has become an increasingly popular treatment option. However, bariatric surgery can contribute to esophageal dysmotility and lead to worsening or development of GERD, two conditions that are already frequently seen in the obese population. We review the effects of the various types of bariatric surgeries on the esophagus, specifically focusing on sleeve gastrectomy, Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding.

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Magnetic sphincter augmentation at the time of bariatric surgery: an analysis of the MBSAQIP

Cited by 12 publications

References 25 publications

Magnetic Sphincter Augmentation for Hiatus Hernia and De Novo Gerd after Sleeve Gastrectomy

Magnetic Sphincter Augmentation for Hiatus Hernia and De Novo Gerd after Sleeve Gastrectomy

The role of magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease

Effects of Obesity Surgery on GERD and Esophageal Motility

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