LINX1 webWhen you were young, you thought nothing about a late-night pizza delivery or a run to an all-night greasy diner. For many older adults, however, such an indulgence today would result in a painful, restless night. “Over the years, we’ve become more susceptible to developing gastroesophageal reflux disease (GERD), which can cause acid indigestion in the throat or a burning sensation in the chest, commonly called heartburn”, said Noel Martins, MD, of St. Luke’s Gastroenterology Specialists.

GERD develops when stomach contents back up causing symptoms or complications. “As you age your muscles weaken, including the lower esophageal sphincter that fends off heartburn”, Dr. Martins said. “Excessive weight gain, dietary indiscretions, taking certain medications, and having a hiatal hernia can increase the frequency and severity of GERD.

A hiatal hernia occurs when the upper part of the stomach pushes up into the chest cavity. It is more common with increasing age.”

“Fortunately, we have seen impressive results from a new procedure called LINX,” he added. The LINX device is a string of magnetic titanium beads on a wire that is custom fit to each patient.

During the procedure, the device is placed surgically at the gastroesophageal junction. The magnets help keep the lower esophageal sphincter closed to prevent reflux. When a patient swallows, the LINX device opens temporarily to allow food and liquids into the stomach.

St. Luke’s University Health Network was the first provider in the Lehigh Valley region to offer a minimally invasive robotic surgery to place a LINX device in patients suffering from gastroesophageal reflux disease (GERD) and repair associated hiatal hernias. St. Luke’s thoracic surgeon Dustin Manchester, MD, and bariatric surgeon Maher El Chaar, MD, have both been trained in the LINX procedure.

In April, Sandra Cahill of Wilson Borough was the first St. Luke’s patient to have the LINX device implanted robotically. In addition, Dr. Manchester repaired a hiatal hernia that had wrapped around her stomach and diaphragm.

“Before the procedure, I always felt like there was something in the back of my throat. After I ate, I had stomach pains,” she said. “Now, I feel a lot better.

The healing process was very smooth with no issues. And, everyone treated me so well. Dr. Manchester even called me himself to see how I was feeling that evening.” Cahill used to eat very quickly. She had to learn to eat more slowly. Now, she feels full sooner and has even lost 20 pounds since the procedure. The heartburn stopped immediately.

Similarly, Matthew Citino of Summit Hill said he hasn’t had heartburn a single time since the surgery and no longer needs any medication.

“Before, I couldn’t even lie down at night,” he said of the time before the procedure. His acid reflux was so severe that lying down in bed would upset his stomach to the point that it sometimes caused vomiting. “Since the surgery I feel normal again,” he added. “I no longer have to worry about taking pills and I can eat whatever I want. I’m Italian and grew up on pasta, red sauce and meatballs. I like hot food too and now I can enjoy the foods I love again.”

Most patients stay in the hospital for one night and are discharged to home the following day. As this procedure is performed minimally invasively with small incisions, most patients have very little pain and can return to work within a few weeks.

“St. Luke’s is privileged to be the first center in the Lehigh Valley to offer the LINX procedure robotically,” Dr. Manchester notes. “This procedure has significantly fewer complications of recurrence, slippage or gas bloating than the traditional fundoplication.

Moreover, the LINX device does not change the patient’s own natural gastric anatomy [as is the case with a traditional fundoplication].”

Using robotic assisted surgery to place the LINX and repair the patient’s hiatal hernia when appropriate has benefits for both the surgeon and the patient. “It gives the surgeon better visualization and an easier way to find the anatomical planes,” Dr. El Chaar says. “It’s also less painful than standard laparoscopic approach for the patient and only requires an overnight stay at the hospital.”

Adds Dr. Manchester: “Robotic assisted surgery allows the surgeon practically unlimited dexterity and precision of movements all through small, minimally invasive incisions,” he explains. “In addition, for patients with larger hernias, robotic surgery gives the surgeon more controlled access up into the chest, allowing for a more complete dissection of the hernia, thus leading to fewer recurrences.”

Dr. El Chaar says that candidates for the LINX procedure include any patient who has reflux that is not controlled with medication or anybody who wants to be off anti-acid medication. “St. Luke’s is committed to offering the best available treatment options to patients and using the latest technologies,” Dr. El Chaar explains. “We have developed a comprehensive heartburn center where we offer patients a multitude of options. We are excited that the LINX is now one of them.”

For more information about the LINX procedure, call St. Luke’s at 1-866-785-8537 or visit

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