There are two surgeries to treat GERD. The first is LINX and the second is Hiatal hernia repair and Nissen. They are both surgeries to treat GERD refractory to medical management, but LINX is a newer surgery based on innovative technology in the form of a magnetic and titanium bracelet placed around the lower esophageal sphincter to augment (tighten) the area that weakened which leads to reflux of acid. Dr. Tsuda and Dr. Ryan are the only surgeons in Nevada who are trained to perform this surgery.
Nissen fundoplication is the process of wrapping the upper portion of the stomach around the same lower esophageal sphincter, also augmenting it. It is the more common surgery done and the standard of care for reflux at this time. The appeal of the LINX is that it is a device placed and is therefore reversible if need be (although we certainly don’t like removing it). Also the patient is (by necessity) on a regular diet from post operative day 0, as oppose to a Nissen patient who is on a modified liquid diet for a month after surgery. The downside to the LINX is that there is very specific criteria for those who would benefit as determined by the patients preoperative pH monitoring and manometry testing. Anyone who doesn’t qualify for a LINX will usually be a candidate for a fundoplication.
Talk to Dr. Ryan or Dr. Tsuda about which surgery will work for you.