***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND This study was undertaken to evaluate our clinical experience during a 6-year period with an implantable device that augments the lower esophageal sphincter for  gastroesophageal reflux disease ( GERD ) .  The device uses magnetic sphincter augmentation ( MSA ) to strengthen the antireflux barrier . STUDY DESIGN In a single-center , prospect i ve case series , 100 consecutive patients underwent laparoscopic MSA for GERD between March 2007 and February 2012 . Clinical outcomes for each patient were tracked post implantation and compared with presurgical data for esophageal pH measurements , symptom scores , and proton pump inhibitor ( PPI ) use . RESULTS Median implant duration was 3 years ( range 378 days to 6 years ) . Median total acid exposure time was reduced from 8.0 % before implant to 3.2 % post implant ( p < 0.001 ) . The median GERD Health Related Quality of Life score at baseline was 16 on PPIs and 24 off PPIs and improved to a score of 2 ( p < 0.001 ) . Freedom from daily dependence on PPIs was achieved in 85 % of patients . There have been no long-term complications , such as device migrations or erosions . Three patients had the device laparoscopically removed for persistent GERD , odynophagia , or dysphagia , with subsequent resolution of symptoms . CONCLUSIONS Magnetic sphincter augmentation for GERD in clinical practice provides safe and long-term reduction of esophageal acid exposure , substantial symptom improvement , and elimination of daily PPI use . For c and i date s of antireflux surgery who have been carefully evaluated before surgery to confirm indication for MSA , MSA has become a st and ard treatment at our institution because control of reflux symptoms and pH normalization can be achieved with minimal side effects and preservation of gastric anatomy Background The techniques available for antireflux surgery have exp and ed with the introduction of the magnetic sphincter augmentation device ( MSAD ) for gastroesophageal reflux disease ( GERD ) . Methods A prospect i ve , multicenter registry evaluated MSAD and laparoscopic fundoplication ( LF ) in clinical practice ( Clinical Trials.gov identifier : NCT01624506 ) . Data collection included baseline characteristics , reflux symptoms , proton-pump inhibitor ( PPI ) use , side effects , and complications . Post-surgical evaluations were collected at one year . Results At report , 249 patients ( 202 MSAD patients and 47 LF patients ) had completed one-year follow-up . The LF group was older and had a greater frequency of large hiatal hernias and Barrett ’s esophagus than the MSAD group ( P < 0.001 ) . The median GERD-health related quality of life score improved from 20.0 to 3.0 after MSAD and 23.0 to 3.5 after LF . Moderate or severe regurgitation improved from 58.2 to 3.1 % after MSAD and 60.0 to 13.0 % after LF ( P = 0.014 ) . Discontinuation of PPIs was achieved by 81.8 % of patients after MSAD and 63.0 % after LF ( P = 0.009 ) . Excessive gas and abdominal bloating were reported by 10.0 % of patients after MSAD and 31.9 % following LF ( P ≤ 0.001 ) . Following MSAD , 91.3 % of patients were able to vomit if needed , compared with 44.4 % of those undergoing LF ( P < 0.001 ) . Reoperation rate was 4.0 % following MSAD and 6.4 % following LF . Conclusion Antireflux surgery should be individualized to the characteristics of each patient , taking into consideration anatomy and propensity and tolerance of side effects . Both MSAD and LF showed significant improvements in reflux control , with similar safety and reoperation rates . In the treatment continuum of antireflux surgery , MSAD should be considered as a first-line surgical option in appropriately selected patients without Barrett ’s esophagus or a large hiatal hernia in order to avoid unnecessary dissection and preserve the patient ’s native gastric anatomy . MSAD is an important treatment option and will exp and the surgeon ’s role in treating GERD Objectives : One- and 2-year evaluation of a feasibility trial ( clinical trials.gov registration numbers NCT01057992 , NCT01058070 , and 01058564 ) to assess the safety and efficacy of a laparoscopically implanted sphincter augmentation device for the treatment of  gastroesophageal reflux disease ( GERD ) .  Methods : A sphincter augmentation device ( LINX Reflux Management System ; Torax Medical , Sho review , MN ) , design ed to prevent reflux due to abnormal opening of the lower esophageal sphincter ( LES ) , was laparoscopically implanted at the gastroesophageal junction in 44 patients . At baseline , all patients had abnormal esophageal acid exposure on 24-hour pH monitoring and improved , but persistent , typical GERD symptoms while on acid suppression therapy with proton pump inhibitors ( PPIs ) . The device comprises a miniature string of interlinked titanium beads , with magnetic cores , placed around the gastroesophageal junction . The magnetic bond between adjacent beads augments sphincter competence . The beads temporarily separate to accommo date a swallowed bolus , allow belching or vomiting , and reapproximate to augment the LES in the closed position . Patients were evaluated after surgery by  GERD Health-Related Quality of Life symptom score , PPI usage , endoscopy , esophageal manometry , and 24-hour esophageal pH monitoring . Results : The total mean GERD Health-Related Quality of Life symptom scores improved from a mean baseline value of 25.7 to 3.8 and 2.4 at 1- and 2-year follow-up , representing an 85 % and 90 % reduction , respectively ( P < 0.0001 ) . Complete cessation of PPI use was reported by 90 % of patients at 1 year and by 86 % of patients at 2 years . Early dysphagia occurred in 43 % of the patients and self-resolved by 90 days . One device was laparoscopically explanted for persistent dysphagia without disruption of the anatomy or function of the cardia . There were no device migrations , erosions , or induced mucosal injuries . At 1 and 2 years , 77 % and 90 % of patients had a normal esophageal acid exposure . The mean percentage time pH was less than 4 decreased from a baseline of 11.9 % to 3.1 % ( P < 0.0001 ) at 1 year and to 2.4 % ( P < 0.0001 ) at 2 years . Patient satisfaction was 87 % at 1 year and 86 % at 2 years . Conclusions : The new laparoscopically implanted sphincter augmentation device eliminates GERD symptoms without creating undue side effects and is effective at 1 and 2 years of follow-up Background The high prevalence of gastroesophageal reflux disease continues to encourage the development of treatment modalities to fill the gap between acid-suppression therapy and the laparoscopic Nissen fundoplication . The Magnetic Sphincter Augmentation device has been design ed to augment the lower esophageal sphincter barrier using magnetic force . A multi-center feasibility trial was done to evaluate safety and efficacy . Methods Patients with typical heartburn ( at least partially responding to proton-pump inhibitors ) , abnormal esophageal acid exposure , and normal esophageal peristalsis were enrolled . Patients with hiatal hernia > 3 cm were excluded from the study . The device was implanted laparoscopically around the distal esophagus . Results Over a 1-year period , 38 out of 41 enrolled patients underwent this procedure in 3 hospitals . No operative complications were recorded . A free diet was allowed since post-operative day one , and 97 % of patients were discharged within 48 h. The mean follow-up was 209 days ( range 12–434 days ) . The GERD-HRQL score decreased from 26.0 to 1.0 ( p < 0.005 ) . At 3 months post-operatively , 89 % of patients were off anti-reflux medications , and 79 % of patients had a normal 24-h pH test . All patients preserved the ability to belch . Mild dysphagia occurred in 45 % of patients . No migrations or erosions of the device occurred . Conclusions Laparoscopic implant of the MSA device is safe and well tolerated . It requires minimal surgical dissection and a short learning curve compared to the conventional Nissen fundoplication Introduction Magnetic sphincter augmentation ( MSA ) of the lower esophageal sphincter restores the antireflux barrier in patients with hiatal hernias ≤3 cm . We performed a prospect i ve study in patients undergoing MSA with the LINX device during repair of paraesophageal and hernias over 3 cm axial component . Methods and procedures Multicenter , prospect i ve study of consecutive patients treated with MSA at the time of repair of hiatal hernias > 3 cm . Results 200 patients ( 110 female ) were treated between March 2014 and February 2017 via laparoscopic hernia repair and MSA . Mean age was 59.5 years , mean BMI 29.4 . 40 % had esophagitis , 20 % intestinal metaplasia , 72 of 77 tested had abnormal pH studies . Preoperative PPI use was reported by 87 % . Eighteen patients had prior hiatal hernia/fundoplication . All had normal function . 78 % of patients had axial hiatal hernia ≥5 cm or large paraesophageal component . Mean operative time was 81 min ( 38–193 ) , EBL was 10 cc . Non-permanent mesh reinforcement of hiatal repair was performed in 83 % of the patients . There were two readmissions for dehydration ; 2 patients with pulmonary embolism , and 1 patient with cardiac ischemia . Nineteen patients required dilation . 156 pts were followed at a median of 8.6 months . GERD-HRQL scores improved from 26 preoperatively to 2 postoperatively . Complete PPI independence was achieved in 94 % ( 147/156 ) . Videoesophagram in 51 patients at median 11 months found 3 asymptomatic hernias <3 cm . One symptomatic patient underwent successful repair of the hernia without MSA manipulation . There have been no device explants , erosions , or migrations to date . Conclusions This prospect i ve study of 200 patients with > 3 cm hernias undergoing MSA with hiatoplasty result ed in favorable outcomes with median of 9 months follow-up . Comparing this to published reports of MSA in patients with <3 cm hernias , the safety and clinical efficacy of MSA are independent of initial hernia size INTRODUCTION Gastro‐oesophageal reflux disease ( GORD ) is a common , chronic debilitating condition . Surgical management traditionally involves fundoplication . Magnetic sphincter augmentation ( MSA ) is a new definitive treatment . We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes . METHODS MSA was introduced into NHS practice following successful acceptance of a cost‐effective business plan and close observation of National Institute for Health and Care Excellence ( NICE ) recommendations for new procedures , including a carefully planned prospect i ve data collection over a two‐year follow‐up period . RESULTS Forty‐seven patients underwent MSA over the 40‐month period . Reflux health‐related quality of life ( GERD‐HRQL ) was significantly improved after the procedure and maintained at one‐ and two‐year ( P < 0.0001 ) follow‐up . Drug dependency went from 100 % at baseline to 2.6 % and 8.7 % after one and two years . High levels of patient satisfaction were reported . There were no adverse events . CONCLUSIONS MSA is highly effective in the treatment of uncomplicated GORD , with durable results and an excellent safety profile . This laparoscopic , minimally invasive procedure provides a good alternative for patients where surgical anatomy is unaltered . Our experience demonstrates that innovative technology can be incorporated into NHS practice with an acceptable business plan and compliance with NICE recommendations BACKGROUND & AIMS Based on results from year 2 of a 5-year trial , in 2012 the US Food and Drug Administration approved the use of a magnetic device to augment lower esophageal sphincter function in patients with gastroesophageal reflux disease ( GERD ) . We report the final results of 5 years of follow-up evaluation of patients who received this device . METHODS We performed a prospect i ve study of the safety and efficacy of a magnetic device in 100 adults with GERD for 6 months or more , who were partially responsive to daily proton pump inhibitors ( PPIs ) and had evidence of pathologic esophageal acid exposure , at 14 centers in the United States and The Netherl and s. The magnetic device was placed using st and ard laparoscopic tools and techniques . Eighty-five subjects were followed up for 5 years to evaluate quality of life , reflux control , use of PPIs , and side effects . 
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Special patient groups ( e.g. , bariatric or large hiatal-hernias ) had promising results too .
The findings of our review suggest that MSA has the potential to bridge the treatment gap between maxed-out medical treatment and LF .