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Published on: March 19, 2018
Magnetic compression anastomosis in gastrointestinal surgery: a systematic review of early human experience
Arshpreet Kaur1, Samreen Shaikh1, Sebastian C Valdivieso Rueda1,2
1Department of Surgery, OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL, 61637, USA.
Introduction:
Magnetic compression anastomosis (MCA) is one of the recent emerging sutureless minimally invasive techniques for maintaining the continuity of the intestine using magnetic compression. Despite its potential advantages, clinical application remains limited due to scarce evidence. The aim of this article is to review the current literature for this alternate method of bowel anastomosis.
Methods:
A systematic review was conducted in accordance with PRISMA 2020 guidelines. MEDLINE, Embase, and the Cochrane Library were searched from inception to 2025. Eligible studies reported MCA use in human subjects for gastrointestinal indications with at least one clinical outcome reported. Study quality was assessed using MINORS criteria for non-randomized studies and CARE guidelines for case reports.
Results:
Thirteen studies comprising 106 patients from nine countries were included (5 prospective first-in-human trials; 2 retrospective cohorts; 6 case reports). Clinical domains spanned adult gastrointestinal obstruction without general anesthesia, post-urological bowel reconstruction, laparoscopic pancreatoduodenectomy reconstruction, metabolic surgery, and congenital rectal atresia. Anastomotic leakage attributable to MCA was 0% (0/106) across all studies, anatomical regions, and device types. Laparoscopic MCA reduced choledochojejunostomy time from 25 to 57 min to a median of 11 min. Pediatric MCA achieved sphincter-preserving atresia repair with excellent 3-year functional outcomes.
Conclusion:
Early clinical evidence suggests that MCA is a safe and feasible alternative to conventional suturing or stapling techniques, with encouraging short-term outcomes. It is a promising alternative technique, especially for high-risk cases who cannot undergo general anesthesia or for those with frozen abdomens. MCA with an endoscopic technique can enable immediate resumption of oncological treatment. Due to limited clinical evidence and lack of sufficient data, further clinical trials are warranted to establish safety, efficacy, and cost-benefit before widespread human application.
Prospero Registration:
1268302.
