{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T21:30:41Z","timestamp":1786397441735,"version":"build-2736575974"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100013015","name":"Cedars-Sinai Medical Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013015","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Magnetic sphincter augmentation (MSA) is a ring of titanium beads that is implanted around the gastroesophageal junction for the management of gastroesophageal reflux disease, providing an alternative to traditional fundoplication. Despite positive outcomes, a subset of patients require device explantation. The safety of patients undergoing explant with revisional surgery remains limited to single-institution experiences. The objective of this study was to compare perioperative outcomes between patients undergoing MSA device explant with revisional surgery and those undergoing primary surgery using a national database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2017\u20132023 American College of Surgeons National Surgical Quality Improvement Program registry was queried for patients undergoing MSA removal with concurrent hiatal hernia repair and fundoplication. These patients were compared to a cohort undergoing primary hiatal hernia repair with fundoplication. Propensity score matching was performed in a 1:1 fashion based on baseline demographics, comorbidities, and procedure type to minimize selection bias. Outcomes of interest included operative time, length of stay, thirty-day postoperative complications, readmissions, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 49,535 patients underwent foregut surgery during the study period, of whom 40 (0.01%) underwent MSA device explant with revisional surgery. Following propensity score matching, each cohort included 40 patients. Overall demographics between the MSA and primary hernia repair groups were similar with the majority being female (87.5%), mean ages of 58.3 and 58.8\u00a0years, and BMI of 29.1 and 28.9\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively. For both groups, the complication rate was 2.5% for readmission requiring revisional surgery, and median length of stay was one day. Median operative time was comparable. No mortalities were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study represents the largest national analysis of patients undergoing MSA device explant with concurrent revisional foregut surgery. Findings suggest that MSA device removal with hiatal hernia repair and fundoplication is safe, with perioperative outcomes equivalent to those of primary foregut surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13081-0","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:51:41Z","timestamp":1783698701000},"page":"7097-7101","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No added risk: national outcomes of magnetic sphincter explant with hiatal hernia repair and fundoplication"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9706-2168","authenticated-orcid":false,"given":"Sienna","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Wisniowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond","family":"Huynh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulmeet","family":"Sandhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Cunneen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Burch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"13081_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-62795-1","volume":"10","author":"JS Nirwan","year":"2020","unstructured":"Nirwan JS, Hasan SS, Babar Z-U-D, Conway BR, Ghori MU (2020) Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): systematic review with meta-analysis. Sci Rep 10:5814. https:\/\/doi.org\/10.1038\/s41598-020-62795-1","journal-title":"Sci Rep"},{"issue":"1","key":"13081_CR2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.14309\/ajg.0000000000001538","volume":"117","author":"PO Katz","year":"2022","unstructured":"Katz PO, Dunbar K, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ (2022) ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 117(1):27\u201356. https:\/\/doi.org\/10.14309\/ajg.0000000000001538","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"13081_CR3","doi-asserted-by":"publisher","first-page":"3769","DOI":"10.1007\/s00464-023-09878-y","volume":"37","author":"S Eriksson","year":"2023","unstructured":"Eriksson S, Schwameis K, Ayazi S, Hoppo T, Zheng P, Jobe BA (2023) Removal of the magnetic sphincter augmentation device: an assessment of etiology, clinical presentation, and management. Surg Endosc 37(5):3769\u20133779. https:\/\/doi.org\/10.1007\/s00464-023-09878-y","journal-title":"Surg Endosc"},{"issue":"4","key":"13081_CR4","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1177\/26345161241263051","volume":"4","author":"T Andreae","year":"2024","unstructured":"Andreae T, Elshafei M, Gossage JA, Kersting T, Bell R (2024) Current clinical evidence for magnetic sphincter augmentation: a scoping review. Foregut: J Am Foregut Soc 4(4):442\u2013453. https:\/\/doi.org\/10.1177\/26345161241263051","journal-title":"Foregut: J Am Foregut Soc"},{"issue":"4","key":"13081_CR5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1177\/1756283X13486311","volume":"6","author":"L Bonavina","year":"2013","unstructured":"Bonavina L, Saino G, Lipham JC, DeMeester TR (2013) LINX\u00ae Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux. Ther Adv Gastroenterol 6(4):261\u2013268. https:\/\/doi.org\/10.1177\/1756283X13486311","journal-title":"Ther Adv Gastroenterol"},{"issue":"1","key":"13081_CR6","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s11605-019-04331-9","volume":"24","author":"S Ayazi","year":"2020","unstructured":"Ayazi S et al (2020) Magnetic sphincter augmentation and postoperative dysphagia: characterization, clinical risk factors, and management. J Gastrointest Surg 24(1):39\u201349. https:\/\/doi.org\/10.1007\/s11605-019-04331-9","journal-title":"J Gastrointest Surg"},{"issue":"8","key":"13081_CR7","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1056\/NEJMoa1205544","volume":"368","author":"RA Ganz","year":"2013","unstructured":"Ganz RA et al (2013) Esophageal sphincter device for gastroesophageal reflux disease. N Engl J Med 368(8):719\u2013727. https:\/\/doi.org\/10.1056\/NEJMoa1205544","journal-title":"N Engl J Med"},{"issue":"8","key":"13081_CR8","doi-asserted-by":"publisher","first-page":"4956","DOI":"10.1007\/s00464-025-11842-x","volume":"39","author":"SJ Bloomsburg","year":"2025","unstructured":"Bloomsburg SJ, Duncan AJ, Chen S (2025) The failure pattern for the magnetic sphincter augmentation device: a single-institution case series with literature review. Surg Endosc 39(8):4956\u20134964. https:\/\/doi.org\/10.1007\/s00464-025-11842-x","journal-title":"Surg Endosc"},{"issue":"11","key":"13081_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab036","volume":"34","author":"J DeMarchi","year":"2021","unstructured":"DeMarchi J, Schwiers M, Soberman M, Tokarski A (2021) Evolution of a novel technology for gastroesophageal reflux disease: a safety perspective of magnetic sphincter augmentation. 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Langenbecks Arch Surg 406(7):2545\u20132551. https:\/\/doi.org\/10.1007\/s00423-021-02294-7","journal-title":"Langenbecks Arch Surg"},{"key":"13081_CR14","doi-asserted-by":"publisher","unstructured":"Buniak N et al (2023) GERD symptoms often improve after magnetic sphincter augmentation (MSA) device removal \u2013 an observational study. Research Square. https:\/\/doi.org\/10.21203\/rs.3.rs-2628818\/v1","DOI":"10.21203\/rs.3.rs-2628818\/v1"},{"issue":"6","key":"13081_CR15","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1089\/lap.2017.0025","volume":"27","author":"CD Smith","year":"2017","unstructured":"Smith CD, Ganz RA, Lipham JC, Bell RC, Rattner DW (2017) Lower esophageal sphincter augmentation for gastroesophageal reflux disease: the safety of a modern implant. 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Dr. Scott Cunneen is a speaker\/trainer\/faculty with Covidien and consultant with Applied Medical. Dr. Miguel Burch is a paid consultant for Stryker Endoscopy and Medtronic and receives speaker fees from Intuitive Surgical. Remaining authors have no disclosures.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}