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LINX Surgery for GERD

The LINX Reflux Management System is an implanted, bracelet-like medical device about the size of a quarter and made of titanium beads and a magnetic clasp. The LINX device is used to assist the Lower Esophageal Sphincter in closing fully, to avoid the reflux of gastric juices into the esophagus and causing chronic acid reflux or GERD.

This device was created to address some of the more significant lifestyle considerations that fundoplication patients must live with after their surgical procedure.

How LINX is Implanted

The entire procedure takes about 15 to 20 minutes in the operating room under general anesthesia. The procedure is performed on an outpatient basis, which unlike a fundoplication, means that patients can return home on the same day of surgery. During the procedure, the surgeon places the device around the lower esophageal sphincter and closes the magnetic clasp. The pressure provided by the device is sufficient to keep gastric juices in the stomach, while the magnetic bracelet stretches to allow food to pass through at mealtime.

Benefits of LINX Surgery

  • Clinical data has shown that the LINX procedure offers excellent results in reducing or eliminating GERD symptoms. These results are similar to those of fundoplication. Most patients do not require further medication for their heartburn and do not experience symptoms in the five years after surgery.
  • While the LINX device is supposed to be a permanent implant, it is reversible and removable with a simple outpatient procedure. Further, there is some evidence that the scar tissue created by the implantation of the device offers some additional LES support even after the device has been removed.
  • Unlike a fundoplication, LINX patients do not have significant dietary restrictions. In fact, a regular diet is encouraged immediately after the procedure.
  • The LINX device allows for belching and vomiting more easily than a fundoplication and while it may still be uncomfortable, it is not as painful.

Risks & Considerations of The LINX Device

  • Of course, there are risks of any surgical procedure which can include reaction to anesthesia, blood loss, pain, infection and in very rare cases, death.
  • There is a chance that the device may fail. Failure of a LINX device may include slippage, which reduces the effectiveness of the device and erosion into the esophagus which can cause significant pain and difficulty swallowing. Both of these complications require revisional surgery.
  • The risks and considerations of implanting a LINX device in patients with severe esophagitis (grade C or D), or Barrett’s Esophagus, is largely unknown
  • The LINX device is MRI conditional up to 1.5T – Newer 3T MRI machines may not be acceptable
  • Patients with a hiatal hernia larger than 3 cm may also require a hiatal hernia repair prior to placing the LINX device

This is not a comprehensive list of risks and considerations of the LINX device. Please speak to your general surgeon or gastroenterologist to learn more about whether this option is appropriate for your particular circumstance.


  1. Bonavina L, Saino G, Lipham JC, Demeester TR. LINX(®) Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux. Therap Adv Gastroenterol. 2013;6(4):261–268
  2. Bonavina L, DeMeester TR, Ganz RA. LINX ™ Reflux Management System: magnetic sphincter augmentation in the treatment of gastro-esophageal reflux disease. Expert Rev Gastroenterol Hepatol. 2012;6(6):667–674

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