Use of a magnetic sphincter for the treatment of GERD: a feasibility study

Esophageal Sphincter Device for Gastroesophageal Reflux Disease

“…The device involves the use of magnetic attraction through adjacent magnetic beads, which augments the resistance of the esophageal sphincter to abnormal opening associated with reflux. [9][10][11] Each bead contains a sealed core of magnetic neodymium iron boride that produces a precise and permanent force of attraction. The beads are connected to adjacent beads by small wires that allow the device to expand.…”

“…7,8 Augmentation of the esophageal sphincter with a magnetic device may provide an alternative treatment for patients who have incomplete symptom relief with proton-pump inhibitors or who are reluctant to undergo surgical fundoplication. [9][10][11] The aim of magnetic sphincter augmentation is to improve the barrier function of the sphincter without altering the hiatal and gastric anatomy or interfering with swallowing, belching, or vomiting. The feasibility of this concept was shown in a pilot study.…”

The Disappointing Performance of the new „Magnetic Sphincters”: a Wrong Idea or a Wrong Realization?

“…In fact, the preliminary report [2] showed an improvement at 6 months after operation in only 5 of 14 patients with an average increase of only 12 mmHg in anal resting pressure, whereas in another study [8], the Wexner score decreased only in about 50% of 19 patients controlled at 6 months with problems of difficult evacuation in some patients [2,8]. These disappointing results could be explained also in this case by the fibrous tissue encapsulation of the moving parts of the device [3], that can remain blocked in an open or closed position, causing, respectively, incontinence or stenosis.…”

“…In addition, 68% of the patients developed postoperative dysphagia, which in 27% of cases requested esophageal dilation and in some cases removal of the device. The cause of the device dysfunction could lie in a progressive encapsulation in fibrous tissue, as observed in a swine model 44 weeks after [3], and also in human cases where the device was removed [4]. Fibrin deposition around the wires could have hampered the movements of the magnets blocking the "magnetic collar" in a closed or open position causing, respectively, dysphagia or GER.…”

Benign diseases of the gastro-oesophageal junction

“…This functions as a magnet, and while implanted around the lower oesophageal sphincter it causes an attraction between the opposite oesophageal walls, increasing its pressure. In a non-randomised study, the effectiveness of the method proved to be comparable to the laparoscopic Nissen procedure and, at the same time, burdened with fewer complications [20]. The subsequent new method is the implantation of a device stimulating the lower oesophageal sphincter -EndoStim [21].…”