What is LINX, what can LINX do?

Swiss1Chirurgie informs – The LINX System

Constant acid regurgitation is not only annoying, but can also cause serious secondary diseases. What is summarised in technical language as reflux is an extremely unpleasant restriction of the quality of life for those affected.

The LINX system has been available for years for reflux therapy and has led to extremely positive results. You can find out what LINX is, what LINX can do and how it works in the detailed article, in the video or on the Swiss1Chirurgie website.

Learn more about the reflux therapy procedure

There are probably around 20 percent of the population who regularly or chronically complain of reflux of stomach acid into the oesophagus. However, acid regurgitation is not only extremely unpleasant, but can also cause serious health problems, including oesophageal cancer.

With LINX, a system is available that can effectively prevent the backflow of gastric juice into the oesophagus. This system is used as part of a minimally invasive surgical operation. After placement of the LINX system, the symptoms subside and patients can return to a normal life in most cases.

What is LINX?

In principle, the LINX system is a magnetic ring chain. At first glance, the system can be compared to an elastic pearl necklace, whereby here the pearls are on magnets that are titanium-coated and thus completely harmless to the organism. Due to the attractive forces acting on the magnetic beads, they are repeatedly attracted to each other in the absence of counterpressure, which leads to a narrowing of the chain. When mechanical tension is applied to the system, the chain expands and widens the passage.

What can LINX do?

The LINX system is placed around the lower end of the oesophagus in a minor surgical procedure. The attraction of the titanium-coated magnetic beads creates a reliable closure of the oesophageal outlet without compressing the oesophagus. Only when, for example, a certain internal pressure is exerted on the oesophagus by the intake of food, does the magnetic ring open so that the food pulp or even liquids can enter the stomach unhindered. In this way, the normal function of the oesophagus is efficiently supported and the reflux of gastric juice into the oesophagus can be prevented. The bottom line is that LINX is strong enough to close the oesophageal junction into the stomach, but weak enough to allow air to escape from the stomach or vomiting to occur.

Practical experience

The LINX system has been known and proven for years. In the Swiss1Chirurgie clinics, this system is preferably used for reflux therapy whenever possible. The experience is extremely good, which includes that there are hardly any complications with the system during and after the surgical procedure. Since 2015, Prof. Dr. Jörg Zehetner has already treated over 250 patients with the LINX system. For most people with reflux symptoms, this system is the first choice, provided there is otherwise normal oesophageal function.

In order to assess this condition, a preliminary assessment of oesophageal function and reflux symptoms is essential. This preliminary examination includes a gastroscopy and a functional test of the oesophagus. Ideally, these examinations are supplemented by manometry, which means measuring the pressure in the oesophagus.

Would you like more information? Do you yourself have complaints due to acid reflux? Then watch the video with Prof. Dr. Jörg Zehetner, visit the Swiss1Chirurgie website or make an appointment at one of the Swiss1Chirurgie clinics in Bern, Brig or Solothurn.

https://v.calameo.com/?bkcode=0061151993dbd1bbf97d6&mode=mini&showsharemenu=false&clickto=embed&autoflip=4

Podcast Topic: Inguinal hernias and modern 3-D net care

https://hernien.podigee.io/1-neue-episode/embed?context=external&theme=default

Welcome to the new Swiss1Chirurgie podcast. In the current podcast of the Hernia Centre of Swiss1Chirurgie, we look at the topic of hernias today. The focus will be on inguinal hernias and therapy with the 3-D net.

My name is Jörg Zehetner. This podcast series is intended as patient information for those affected and all those who would like to deal with the topic of hernias.

First of all, it must be clarified what inguinal hernias are.

Inguinal hernias are weaknesses in the abdominal wall in which the abdominal wall tissue tears and organs behind it break through the abdominal wall completely or partially. In an inguinal hernia, this breakthrough through the abdominal wall takes place in the groin area.

Such hernias are mainly diagnosed in men. Women around the age of 50 can also be affected by hernias. Outwardly conspicuous are bulges in the groin area, which appear more or less clearly.

Now the question arises as to how hernias actually occur.

Inguinal hernias can already be observed in newborns. The reason for this is that in male babies, for example, the abdominal wall in the area of the spermatic cords has not yet closed completely. Such hernias are treated surgically after diagnosis in the first year of life.

In contrast to hernias in newborns, hernias in men are mostly seen between the ages of 40 and 50. Men aged 60 and over suffer most frequently from inguinal hernias.

Basically, the cause of every inguinal hernia, regardless of age or gender, is due to a weakness in the abdominal wall in the groin area.

How do inguinal hernias make themselves felt?

A hernia can often be suspected when there is persistent mild to moderate pain in the groin area. This pain can also be severe and stabbing. Often the pain radiates into the thigh and, in men, into the testicles. The pain is most noticeable when carrying heavy loads or as stabbing or pulling pain when working overhead.

If such pain is repeatedly felt in the indicated areas, a more precise diagnosis by the family doctor or the specialised specialist is recommended.

How are inguinal hernias diagnosed?

Experienced surgeons can already make a reliable diagnosis by palpating the groin area. In this procedure, the surgeon places his hand in the patient’s groin and makes him cough willingly. The coughing thrust causes the hernia to bulge in the affected region and can be felt.

It is worth noting that there are also hernias that are not reducible. This means that such hernias cannot be pushed back to their original position by applying light pressure. Then the bulges remain outside the abdominal wall, which not infrequently can also lead to incarceration.

Incarceration of a hernia is an acute complication and must be treated surgically immediately, if possible on the same day. Prolonged entrapment, especially of parts of the intestine, can significantly restrict or even completely stop blood flow to the organs. In the final consequence, this leads to considerable circulatory disturbances and even to the death of parts of the affected organ. This ultimately means a perforation, as a leakage, of the small intestine with life-threatening consequences. Such consequences are dangerous peritonitis and other serious complications. Partly because of these complications, hernias should always be taken very seriously, as they pose a serious threat to the health and, in extreme cases, the life of the patient.

In the case of rather asymptomatic hernias, which are neither noticed nor felt by the patient, it is possible to continue to wait and observe. However, if there is occasional stabbing or pulling pain in the groin area, a thorough examination by a specialist is also urgently required. This is the only way to reliably assess the urgency of further medical and surgical measures.

If the symptoms are unclear, which is often the case with very overweight patients, for example, the surgeon can use ultrasound examination in the groin area to make a more precise assessment of the disease pattern. An abdominal CT, i.e. a computer tomography of the abdominal area, or a magnetic resonance examination can also provide information about hernias that are not recognised or cannot be clearly diagnosed.

Inguinal hernias often occur on both sides. If there is a large hernia on one side, there is a good chance that there is a smaller or equally large hernia on the other side of the body. For this reason, both sides are always examined if an inguinal hernia is suspected, even if the hernia itself is initially only felt by the patient on one side. In this context, a bilateral correction of the abdominal wall is recommended, although the pain and discomfort may only be observed on one side.

The surgical treatment of inguinal hernias

Depending on the age of the patient, the size of the hernia, the general condition and the previous cardiological findings, an inguinal hernia is operated on either openly or laporoscopically, i.e. with a minimally invasive procedure.

Open surgery is preferred for very large fractures. This is also true if the fractures extend into the scrotum in men or if there is a previous cardiological condition. A recurrent hernia is also treated in an open operation. A recurrent hernia is a hernia closure operation that has already been performed, but was unsuccessful.

A laporoscopic correction of the inguinal hernia is the gentler therapy for primarily normal-sized inguinal hernias. This is a so-called keyhole operation, which is performed through quite small incisions.

Swiss1Chirurgie uses a unique technique in laporoscopic therapy. A small incision is made at the upper edge of the navel. A small camera is inserted through this opening behind the abdominal muscle on the right side. By forcing in CO2 gas, a space is created between the peritoneum and the abdominal muscle. In this way, the abdominal cavity can be excellently viewed in the direction of the groin and surgically evaluated.

Due to a special blunt surgical technique, nerves, tissue and veins can be well protected. Once sufficient space has been created in the groin area, the organs can be pushed back into their original position.

The nets are then inserted to close the openings in the abdominal wall. These nets reliably and permanently close the openings in the abdominal wall. For the nets, Swiss1Chirurgie relies on products from the company Bard, which are already three-dimensionally preformed. Hence the term 3-D net therapy. These ultra-light nets are offered in three sizes, so that practically all hernia sizes can be treated with them.

In addition to the sizes small, medium and large, the nets are also prepared for left-sided or right-sided use. The decision on which size to use is up to the operating surgeon and depends on the size of the hernia and the quality of the surrounding tissue.

Bard’s 3-D nets are made of a very light and non-decomposing polypropylene and are fixed to the abdominal wall by a special adhesive for small to medium-sized hernias. All surgeons at Swiss1Chirurgie use the same techniques.

Only in the case of large hernias is the net additionally fixed to the abdominal wall with polypropylene staples to reliably exclude slippage. Both the use of fibrin glue and the fixation with polypropylene staples enable quite painless therapies.

In the normal course of healing, the 3-D nets grow into the surrounding tissue so that long-term closure of the hernia can be achieved without the recurrent hernias already described.

Postoperative hernia therapy

Patients usually experience mild pain for about one to two days after the operation. After this time, the patients can usually already be discharged home. Painkillers in tablet form make the days after the operation easier and are adjusted individually.

After a hernia operation, it is important for patients to take it easy for about three weeks. During this time, sports, physical exertion, heavy lifting or stretching should be consistently avoided.

The surgical incisions on the skin are closed with self-dissolving glue or sutures so that normal body care and hygiene is possible immediately after the operation. Showering is also no problem with it. However, bathing and swimming should be avoided for at least two weeks.

What is the risk of suffering the same hernia again after such an operation?

This question is asked by many patients. Thanks to the modern surgical techniques used and the fitting of a 3-D net hernia closure, the risk of a recurrence of an inguinal hernia at the operated position is virtually eliminated. Only about one percent of the patients treated in this way will have a similar inguinal hernia again. This means that 99 out of 100 appropriately treated patients can live free of symptoms and complaints. This means that the success rate is extraordinarily high and the risk of a recurrence of a hernia is minimal.

If you have already been treated for inguinal hernia in another clinic or hospital outside of Swiss1Chirurgie and continue to suffer from pulling or stabbing pain, we recommend that you visit one of our practices. This allows us to make a second professional assessment of your specific situation. However, most hernias that have been treated surgically do not require follow-up by the general practitioner or specialist.

Thus, after about three weeks after the operation, patients can again bear a normal load and in most cases can also return to full professional life.

For further questions about inguinal hernias and the therapeutic options, please feel free to contact the specialists at Swiss1Chirurgie. To do so, use the contact options at www.swiss1chirurgie.ch or call one of our clinics.

Thank you for your attention!

This podcast is part of the Helvetius.Life podcast series.

Helvetius.Life is the magazine of Helvetius Holding AG.This is where Swiss1Chirurgie, the Centre for Bariatric Surgery ZFBC, the Gastroenterology Group Practice GGP and the Bern Clinic PZB combine their expertise and services in the interests of our patients’ health.

With Helvetius.Life we inform you about exciting topics from the specialist areas of the clinics and practices, provide insights into the work of specialists, show you what we can do in patients’ testimonials and present new findings, therapies and scientific research results.

We would also like to recommend our website

www.swiss1chirurgie.ch or our app, which you can also find at www.swiss1chirurgie.ch.

Stigmatisation Obesity. What does that mean?

Dr. med. Jörg Zehetner on the problem of obesity and what it means for those affected.

As part of the lecture series of Helvetius Holding AG, Dr. med. Jörg Zehetner, Professor USC, took a stand on the stigmatisation of overweight people and the resulting consequences for those affected. In his lecture in the Saaser-Stube Saas-Fee, the experienced physician, who also deals intensively with obesity problems, described the circumstances that obesity patients have to live with practically every day.

They are among us

At the beginning of the lecture, Dr Zehetner made it clear that practically everyone knows the overweight. In one’s own family, in one’s circle of friends or in the circle of colleagues, they exist everywhere and the number of those affected is constantly increasing. And the lives of patients with obesity are not easy.

Where stigmatisation begins

Look at the fat guy! Oh, she’s fat. The fat man should exercise more. Look what he’s got in his shopping basket, and he’s already fat enough.

This is how the stigmatisation of overweight people begins. Without asking why or wherefore, without taking into account how people are personally affected, they are consciously or unconsciously pigeonholed into a category in which they neither belong nor can free themselves from it. Besides the flippant remarks, there are also those that really hurt and don’t help the people concerned at all.

Reduce prejudices

Anyone who has studied the problems of obesity and adiposity in depth knows that those affected suffer greatly from their current life situation. A first step towards at least reducing this unfortunate situation would be to dismantle popular prejudices. It’s always the best moment for that.

The fight against obesity requires a professional network

Hardly any overweight person with a serious problem will be able to successfully face the disease alone in the long term. Even though overweight surgery is now a proven and successful means of fighting the extra pounds, it requires targeted networking before, during and after the medical intervention. For this purpose, a professional network has been established under the umbrella of Helvetius Holding AG, which provides advice, support and assistance to patients in all phases.

Large social alliance against stigmatisation necessary

The topic of obesity is present everywhere. Not only in everyday life, but also in the media, people are encountering this topic more and more frequently and intensively, in addition to the commonly known jokes and remarks about being overweight. From stigmatisation, the path to discrimination is usually a very short one. Obese people are associated with a conceptual world that is anything but pleasant or appreciative. Especially when you don’t know these people personally. This stigmatisation extends far into the personal and social lives of those affected. Even professional life is not excluded. To change this, a large social consensus is needed.

Steps out of stigmatisation

If the spiral of stigmatisation and discrimination against overweight people is to be broken, a clear line is needed. And this begins precisely where obesity is understood as a disease and thus also as treatable and curable. Only then can an active approach be made to these people, who can then actively face their problems themselves without having to continue to hide.

A further step would be to significantly rethink the approach to these patients. And in every area of life and in every encounter with overweight people. Only when the stigma is taken away from these people will they themselves be able to actively enter into the process of their recovery. Dignity, respect and tolerance are exactly the right keywords here.

It is important to also perceive overweight people as valuable members of our society and to recognise that they are not lazy, sedentary, unpleasant and low performers, but sick. And something can be done about diseases, including morbid obesity.

Define obesity as a disease

Anyone who takes a closer look at overweight and obesity will quickly be able to understand them as actual diseases. As with any organic disease, there are clear definitions and developments, but also therapeutic interventions that clearly speak for a clinical picture. A first indication of this is the division into different classifications of overweight, starting from the Body Mass Index, BMI.

Although obesity surgery is a helpful intervention, it does not by itself solve the problem. Being morbidly overweight is and remains a chronic disease that requires lifelong attention, but not disparaging stigmatisation.

More in-depth information on the topic is available in the video recording of the lecture (LINK) and directly on the Swiss1Chirurgie website.