title: Lower Esophageal Magnetic Sphincter Augmentation for Persistent Reflux After Roux-en-Y Gastric Bypass.
abstract: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a good option for the treatment of gastroesophageal reflux disease (GERD) in the obese population. However, some patients have significant reflux despite this procedure, and their treatment might be challenging. Laparoscopic lower esophageal magnetic sphincter augmentation (MSA) has been introduced into clinical practice with encouraging results. Currently, MSA is only approved for patients with hiatal hernias that are less than 3 cm and without history of antireflux procedures. We present two cases of MSA for the treatment of persistent GERD after LRYGB. Since this is an off-label use of this procedure, both patients underwent extensive evaluation before proceeding with surgery. Excellent results were obtained with a significant improvement in symptoms as well as their GERD Health-Related Quality of Life scores.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, 72 East Concord St., Boston, MA, 02118, USA. jamunoz@bu.edu.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Muñoz-Largacha
authors.affiliation: Department of Surgery, Division of Minimally Invasive and Weight Loss Surgery, Boston University School of Medicine, 72 East Concord St., Boston, MA, 02118, USA. donald.hess@bmc.org.
authors.forename: Donald T
authors.initials: DT
authors.lastname: Hess
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, 72 East Concord St., Boston, MA, 02118, USA. virginia.litle@bmc.org.
authors.forename: Virginia R
authors.initials: VR
authors.lastname: Litle
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, 72 East Concord St., Boston, MA, 02118, USA. hiran.fernando@bmc.org.|Boston University School of Medicine, 88 East Newton St, Robinson B-402, Boston, MA, 02118, USA. hiran.fernando@bmc.org.
authors.forename: Hiran C
authors.initials: HC
authors.lastname: Fernando
mesh_terms: D000328:Adult; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006551:Hernia, Hiatal / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation
keywords: GERD; GERD-HRQL; LRYGB; Laryngospasm; Magnetic sphincter augmentation; Minimally invasive surgery; Obesity