ClinicalTrials.gg
TerminatedNCT04695171Updated Feb 9, 2026

LINX Reflux Management System or Fundoplication Clinical Study in Patients With Hiatal Hernia >3 cm

An observational study in Hiatal Hernia Large, Gastro Esophageal Reflux and Hiatal Hernia, sponsored by Foregut Research Foundation. Terminated at 6 sites in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2026-02-09.

Sponsored by Foregut Research Foundation · Observational

Why this study was terminated
The study was terminated early. The sponsor will focus on prospective randomized controlled studies at this time. Funding removed.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
336
Ages
21 Years and older
Sex
All
01

Study summary

The cohort registry is both retrospective and prospective, multicenter surveillance of subjects who underwent a prior hiatal hernia repair and Magnetic Sphincter Augmentation or fundoplication construction more than 2 years prior to initial study visit.

Read the detailed description

The cohort registry is both retrospective and prospective, multicenter surveillance of subjects who underwent a prior hiatal hernia repair and anti-reflux surgery with either Magnetic Sphincter Augmentation (MSA) using LINX placement or fundoplication construction more than 2 years prior to initial study visit. Subjects will be enrolled by invitation only by participating investigators. Enrollment will consist of 300 LINX MSA patients and 150 fundoplication patients with a total of 450 from 4 sites within the United States. Data will be collected for up to 6 years.The primary objective of this study is to determine the long-term incidence of hiatal hernia recurrence in patients who undergo hiatal hernia repair of a large (>3 cm) hernia with LINX® device placement, and to compare this with hiatal hernia recurrence rates in patients who underwent hiatal hernia repair with fundoplication.

02

Conditions studied

  • Hiatal Hernia Large
  • Gastro Esophageal Reflux
  • Hiatal Hernia
  • Hiatal Hernia, Paraesophageal
  • Reflux, Gastroesophageal
  • Reflux Acid

Keywords

  • GERD
  • LINX
  • Fundoplication
  • MSA
  • Magnetic Sphincter Augmentation
  • MSAD
  • Magnetic Sphincter Augmentation Device
03

In context

Gastroesophageal Reflux

1,211 studies on the registry are indexed under Gastroesophageal Reflux; 202 are open to participants now.

This study's enrollment of 336 is above the median of 178 across 348 observational studies indexed under Gastroesophageal Reflux.

Browse Gastroesophageal Reflux studies →

Lead sponsor

Foregut Research Foundation is the lead sponsor of 2 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This clinical evaluation will be conducted at four U.S. investigational centers with up to one hundred and fifty(150) subjects per center (goal of 450 total). Corhort 1 will consist of 300 subjects who were implanted with the LINX® Reflux Management System in the manner described above more than 2 years prior to enrollment to this study. Cohort 2 will consist of 150 subjects who underwent a fundoplication more that 2 years prior to enrollment into this study with similar hiatal hernia size and similar effective esophageal motility.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Subject must be at least 21 years of age and at least the minimum Age of Majority according to applicable state law.
  2. Underwent primary index procedure of laparoscopic repair of a hiatal hernia larger than 3 cm with placement of a LINX® device or construction of a fundoplication for reflux control more than 2 years prior to his/her enrollment or has completed 1 or 2 of the barium swallows and GERD-HRQLs within study time points with or without hiatal hernia recurrence.
  3. Subject is willing and able to cooperate with follow-up examinations.
  4. Subject has been informed of the study procedures and treatment and has signed an .

Exclusion criteria

Exclusion Criteria:

  1. The surgical procedure was completed as an emergency procedure
  2. Currently being treated with another drug or investigational device
  3. Suspected or confirmed esophageal or gastric cancer
  4. Subject has Barrett's esophagus >3cm
  5. Cannot understand trial requirements or is unable to comply with follow-up schedule
  6. Pregnant or plans to become pregnant during the course of the study
  7. Medical illness (i.e. congestive heart failure) that may cause the subject to be non-compliant with or able to meet the protocol requirements or is associated with limited (i.e. less than 3 years)
  8. Diagnosed psychiatric disorder (e.g. bipolar, schizophrenia, etc.), subjects that exhibit depression that are on appropriate medication(s) are allowable.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
336 participants (actual)
Target follow-up
6 Years
Patient registry
Yes

Groups and cohorts

  • Prior Primary Large Hiatal Hernia with LINX Placement MSA

    Patients who were previously implanted with the LINX device during repair of a hiatal hernia \>3 cm \>2 years prior will be asked to complete a quality of life questionnaire at about 3 years and 5 years post procedure. Each participant will complete a barium swallow at 3 and 5 years to determine recurrence of hiatal hernia.

    Device: LINX Reflux Management System

  • Prior Primary Large Hiatal Hernia with Fundoplication

    Patients who previously underwent lower esophageal sphincter reconstruction by fundoplication during repair of a hiatal hernia \>3 cm \>2 years prior will be asked to complete a quality of life questionnaire at about 3 years and 5 years post procedure. Each participant will complete a barium swallow at about 3 and 5 years to determine recurrence of hiatal hernia.

    Procedure: Fundoplication

Interventions

  • DeviceLINX Reflux Management System

    The LINX Reflux Management System consists of a series of titanium beads each with a magnetic core connected with independent titanium wires to form an annular shape when implanted. The attractive force of the magnetic beads is designed to provide additional strength to keep a weak lower esophageal sphincter (LES) closed. During swallowing, the magnetic beads slide away from each other on the independent titanium wire "links" to allow esophageal distention as the bolus passes by.

    Also known as: Magnetic Augmentation System, Magnetic Sphincter Augmentation Device, MSAD, Magnetic Sphincter Augmentation, MSA

  • ProcedureFundoplication

    A surgical procedure where the fundus of the stomach is wrapped around and sutured to the distal esophagus to restore the function of the lower esophageal sphincter in limiting stomach contents from refluxing into the esophagus.

    Also known as: Nissen fundoplication, Partial fundoplication, Toupet fundoplication, Watson fundoplication, Dor fundoplication

06

What researchers measure

Primary outcomes

  1. Incidence of Hiatal Hernia Recurrence

    The primary objective of this study is to determine the long-term incidence of hiatal hernia recurrence in patients who undergo primary hiatal hernia repair of a large (\>3 cm) hernia with LINX® device placement, and to compare this with hiatal hernia recurrence rates in patients who undergo hiatal hernia repair with fundoplication.

    Time frame: Up to 5 years post index procedure

Secondary outcomes

  1. Incidence of Repeat Surgical Intervention

    A secondary objectives are to determine the incidence of repeat surgical intervention with recurrent hernias in patients who received a LINX verses fundoplication.

    Time frame: 5 years

  2. Understanding Patient Reported Symptom Control

    A secondary objective is to understand patient-reported symptom control including PPI use, occurrence rate of gas and bloating, and ability to belch and vomit as measured by comparison of pre- and post-operative satisfaction and ROARS Questionnaire (GERD-Health related quality of life \[HRQL\]) surveys during multiple follow-up time points.

    Time frame: 5 years

07

Study locations

6 sites
  • Keck Medical Center of USC
    Los Angeles, California 90033, United States
  • Institute of Esophageal and Reflux Surgery
    Lone Tree, Colorado 80124, United States
  • South Florida Reflux Center
    Coral Springs, Florida 33065, United States
  • East Carolina University
    Greenville, North Carolina 27858, United States
  • Esophageal Institute
    Pittsburgh, Pennsylvania 15224, United States
  • University of Texas
    Austin, Texas 78712, United States
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 9, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04695171
Lead sponsor
Foregut Research Foundation
Responsible party
Sponsor
First posted
Jan 5, 2021
Start date
Jan 14, 2021
Primary completion
Jan 14, 2026
Completion
Jan 14, 2026
Last update
Feb 9, 2026

Study contacts

Reginald Bell, M.D.
principal investigator · Principal Investigator

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

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