1.1 There are no major safety concerns about laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease (GORD). There is limited evidence of short-term efficacy, but evidence of long-term efficacy is inadequate in quality and quantity. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.
1.2 Clinicians wishing to do laparoscopic insertion of a magnetic titanium ring for GORD should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's long-term efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
1.3 This procedure should only be done by a clinician trained in upper gastrointestinal laparoscopy and with expertise in plication procedures.
1.4 NICE encourages further research into laparoscopic insertion of a magnetic titanium ring for GORD, and may update the guidance on publication of further evidence. Long-term outcome data and comparative trials with other anti-reflux surgery would be helpful.