A novel endoesophageal magnetic device to prevent gastroesophageal reflux

Abstract

The present research demonstrates that it is possible to create at the LES level a dynamic closure of a value considered sufficient to prevent GER, by implanting in the esophageal submucosa of anatomical specimens a magnetic device by means of a special endoluminal probe. Once effectiveness and tolerability of magnets covered by a biocompatible sheath have been demonstrated in vivo, this device could become a simple and effective nonsurgical solution to GER.

The “magnetic collar”: the ultimate solution for gastroesophageal reflux?

“…However, another way of exploiting the magnetic force for keeping the cardias closed has been devised in an experimental study [10], with a safe and simple endoscopic technique that avoids the risk of the complications of Angelchik prosthesis. In this ex vivo study, the cardias were maintained closed by two small magnetic plaques implanted by means of a special endoesophageal device in the esophageal submucosa close to LES with opposite polarities facing, so that they attract one other creating a high pressure zone sufficient to prevent GER.…”

Endoscopic applications of magnets for the treatment of gastrointestinal diseases

“…Magnetic compression without anastomosis is mainly applied for improving gastroesophageal reflux[41-47] or fecal incontinence[48-50], but laparoscopic deployment of the Linx device [a system developed to augment the low esophageal sphincter (LES)] and surgical deployment of the Fenix device (a system developed to augment the anal sphincter) remain as the mainstream treatment (Figure 5). There are only two reports of endoscopic applications of magnets for preventing gastroesophageal reflux in vitro and/or in vivo in a porcine model[46,47]. In 2009, Bortolotti et al[46] deployed an endoesophageal magnetic device into the submucosal layer close to the LES to prevent gastroesophageal reflux.…”

“…There are only two reports of endoscopic applications of magnets for preventing gastroesophageal reflux in vitro and/or in vivo in a porcine model[46,47]. In 2009, Bortolotti et al[46] deployed an endoesophageal magnetic device into the submucosal layer close to the LES to prevent gastroesophageal reflux. Although a high-pressure zone was achieved after insertion of the magnetic valve into the submucosal layer of the ex vivo porcine model (14.2 ± 1.27 mmHg vs 1.5 ± 0.26 mmHg, P < 0.001), mucosal breach could develop easily due to magnetic compression.…”

“…They performed the procedures in both in vitro and in vivo porcine models, in which the two subadventitial tunnels (one in the right side and one in the left side) were created with a biliary stone extraction balloon using the POEM technique, allowing subsequent endoscopic placement and fixation of the magnets[47]. Although this novel method by Dobashi et al[47] appears to be more reasonable than that by Bortolotti et al[46], erosion or fistula could also be developed. Fistula caused by magnetic compression after magnet ingestion has already been reported by many studies[3,51,52].…”

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

“…The endoanal pressure measured with a manometric catheter showed values depending on the attraction force of the magnetic stuff: it was 79.7±13.1 mmHg with neodymium magnets, 43.1±5.6 mmHg with ferrite magnets and 21.6±4,6 mmHg with plastoferrite magnets. In another experimental study [13], the cardia of a swine esophago-gastric specimen was maintained closed by two small magnetic plaques made of plastoferrite implanted by means of a special endoluminal device in the submucosa close to LES with opposite polarities facing. This device generated a high-pressure zone of about 14 mmHg at manometry, that could be increased with stronger magnets.…”