LINX Procedure

Less Invasive Treatment Option for GERD

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The LINX® Reflux Management System is a minimally invasive option that can help reduce acid reflux when medications, lifestyle modifications, and dietary changes are not effective. Duke esophageal surgeons are among the few in the region with experience to perform this latest advance in GERD treatment. They can evaluate your condition and determine if the LINX procedure is the best GERD treatment for you.

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LINX Addresses the Cause of Acid Reflux

Acid reflux, also known as gastroesophageal reflux disease or GERD, occurs when a weak lower esophageal sphincter (valve) allows food and drink to re-enter the esophagus after swallowing. Medications, lifestyle changes, and special diets can effectively treat the symptoms of acid reflux in some people, but they don’t repair the weak valve that is the root of the problem. 

How LINX Treats GERD

The LINX procedure corrects a weak esophageal valve to prevent acid reflux from occurring. The LINX device, which looks like a small, stretchy bracelet, is placed around the lower esophagus through small incisions in the abdomen. A flexible band of magnetic beads expands when you swallow, allowing food and liquid to pass into the stomach. Afterward, the magnets in the device cause the band to contract and the esophageal valve to close. Stomach contents can no longer flow back into the esophagus.

Watch this video to learn how the LINX® Reflux Management System works. 

Advantages of the LINX Procedure

LINX surgery is less invasive than other procedures that correct acid reflux. This means less time in the hospital and a faster recovery. Instead of waiting weeks, you can return to a normal diet the day after surgery. LINX is designed to stay in place permanently to prevent acid reflux but can be removed if needed.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.


Before LINX surgery is recommended, you will meet with a team of specialists, including a gastroenterologist and a thoracic surgeon, for a thorough evaluation. You may undergo one or more of the following tests to determine the cause of your symptoms and if LINX is the best treatment for you.

Upper Endoscopy
Your doctor inserts a flexible tube into your mouth to view the inside of your esophagus, stomach, and small intestine.

During endoscopy, your gastroenterologist uses a device to measure pressures inside your esophagus and assess the ability of your esophagus to contract. When the esophagus works as it should, coordinated contractions move food and liquid down to your stomach.

Esophageal Manometry
A thin, flexible tube called a catheter is inserted through your nose and into your esophagus. It evaluates esophageal motility by monitoring strength and patterns of muscle function within the esophagus.

Esophageal Reflux Test
A catheter or probe placed in the esophagus is used to determine the presence and severity of reflux.

Barium Swallow
A barium liquid is swallowed and travels the length of your esophagus. X-ray images show how the barium moves through your esophagus. This test can detect problems with the structure of your esophagus.

What to Expect During a LINX Procedure

LINX Surgery
Your surgeon will make small incisions in your abdomen. Using small tools passed through these incisions, the LINX device is placed around your lower esophagus, just above the stomach. The hour-long surgery is performed in an operating room under general anesthesia. If a hiatal hernia is present, it can be repaired during the LINX procedure.

After the Procedure
You may go home the same day, or you may stay overnight in the hospital. LINX begins working immediately, and you should be able to eat and drink normally the day after the procedure.

LINX and Insurance
LINX surgery is not covered by all insurance plans. We will discuss this with you to help you understand the costs, insurance requirements, and your options for treatment.

Best Hospital for Gastroenterology and GI Surgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our gastroenterology and GI surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

Leaders in Innovative Techniques
We were the first center in North Carolina to implant the LINX device and to use the TIF device for GERD. We are constantly looking for new, less invasive options to give people freedom from acid reflux.

An Expert Team
People are often referred to our gastroenterologists for the management of uncontrolled acid reflux and travel to us from nearby regions of the U.S. because of our vast experience treating esophageal disorders. Our gastroenterologists have completed specialized training and are highly skilled in the use of endoscopy to diagnose the full range of esophageal disorders. Our board-certified surgeons have additional fellowship training in thoracic surgery. This includes specialized procedures in and around the esophagus.

Access to Clinical Trials
You may be eligible to participate in our ongoing clinical trials, which test new therapies like the LINX® Reflux Management System and innovative approaches to treating GERD and related conditions.

This page was medically reviewed on 11/16/2022 by