title: Endoluminal perforation of a magnetic antireflux device.
abstract: BACKGROUND
  The history of surgical antireflux treatment is coined by the search for better alternatives to Nissen fundoplication. Implantable devices are one option, beginning with the "Angelchik" prosthesis 30 years ago. However, this procedure was left soon because of the high rate of foreign body connected problems (migration, perforation). A modern approach is a magnetic sphincter augmentation device (LINX Reflux Management System, Torax Medical, Shoreview, MN, USA), a magnetic chain which is implanted laparoscopically. Advantages reported are simplicity to apply and good results in reflux control, with up to now only rare complication rates as reported in the literature (Lipham et al. in Dis Esophagus, 2014).
  
  
  METHODS
  We report one case of erosion of the esophagus by a LINX system resulting in severe dysphagia.
  
  
  RESULTS
  A complete endoluminal removal could be achieved by a prototype OTSC-clip remover. Complete remission could be achieved. The technique is presented in detail (video).
  
  
  CONCLUSIONS
  In principle, total endoscopic removal of the LINX device is feasible in case of major erosion.
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. margit.bauer@tum.de.
authors: Margit
authors: M
authors: Bauer
authors: Department of Internal Medicine I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
authors: Alexander
authors: A
authors: Meining
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors: Michael
authors: M
authors: Kranzfelder
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors: Alissa
authors: A
authors: Jell
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors: Rebekka
authors: R
authors: Schirren
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors: Dirk
authors: D
authors: Wilhelm
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
authors: Helmut
authors: H
authors: Friess
authors: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. hubertus.feussner@tum.de.
authors: Hubertus
authors: H
authors: Feussner
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy; D020878:Device Removal; D004939:Esophageal Perforation / Q000209:etiology* / Q000628:therapy; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D059346:Magnets; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D011475:Prosthesis Failure / Q000009:adverse effects*
keywords: Antireflux device; Erosion; Interventional endoscopy; LINX®