First-in-Human Side-to-Side Magnetic Compression Duodeno-ileostomy with the Magnet Anastomosis System

Area of Science:

• Bariatric surgery innovations
• Gastrointestinal surgery
• Medical device technology

Background:

• Traditional gastrointestinal anastomoses using sutures or staples have high rates of bleeding and leaks.
• Novel techniques are needed to improve safety and efficacy in bariatric and metabolic surgery.

Purpose of the Study:

• To evaluate the feasibility and safety of a novel magnet anastomosis system (MS) for creating a side-to-side duodeno-ileal (DI) diversion.
• To assess the effectiveness of this MS DI diversion in promoting weight loss and resolving type 2 diabetes (T2D) in severely obese patients.

Main Methods:

• A side-to-side MS DI diversion was performed in conjunction with sleeve gastrectomy (SG) in 5 female patients with severe obesity (BMI ≥ 35 kg/m²).
• Magnets were endoscopically and laparoscopically placed in the duodenum and ileum, creating a gradual anastomosis.
• Laparoscopic assistance ensured accurate measurements, prevented tissue interposition, and closed mesenteric defects.

Main Results:

• All magnets were successfully placed and expelled, forming durable anastomoses without complications.
• At 12 months, patients achieved significant total weight loss (34.0 ± 1.4%), excess weight loss (80.2 ± 6.6%), and BMI reduction (15.1).
• Type 2 diabetes resolved, with mean HbA1c dropping from 6.8 ± 0.8% to 4.8 ± 0.2% and glucose levels decreasing by 47.0 mg/dL.

Conclusions:

• Side-to-side magnetic compression anastomosis for duodeno-ileostomy diversion is feasible and safe in adults with severe obesity.
• This technique effectively achieves substantial weight loss and resolves type 2 diabetes within one year.
• The MS system offers a promising alternative to traditional anastomosis methods in bariatric surgery.