Linear Magnetic Compression Gastroileostomy Bipartition: Feasibility and Early Outcomes.

Abstract

Minimally invasive magnetic compression technique may simplify the completion of an anastomosis and reduce major surgical complications by obviating permanent staple and suture fixation and enterotomy closures. A multisite study of magnetic gastroileostomy bipartition (MagGI procedure) as a revisional option for suboptimal sleeve gastrectomy (SG) was conducted in adults (BMI [kg/m 2 ] greater than or equal to 30.0-less than or equal to 50.0). After 1 magnet was delivered endoscopically to the ileum and another to the gastric antrum, the magnets were laparoscopically approximated to initiate gradual compression anastomosis. The 90-day primary feasibility endpoint was magnet placement (≥90% of cases), magnet passage without reintervention, and patent anastomosis creation. Secondary endpoints were weight reduction and improved metabolic indicators. Between November 6, 2023, and July 10, 2024, 20 enrolled patients (mean age 46.1 years, BMI 37.1 ± 0.8, weight 101.0 ± 3.0 kg) underwent SG-revisional MagGI. Primary feasibility endpoint was met: 100.0% magnet placement, median passage 31.0 days; patent anastomosis confirmed (20 of 20). 80.0% (47 of 59) of AEs were low grade (Clavien-Dindo grade I and II). Two intestinal tears (grade III) due to bowel forceps were repaired and resolved; 4 grade-IV SAEs, none related to the magnet device. No anastomotic leak or bleeding; no mortality. Respective 6-month (n = 17) and 12-month (n = 7) weight loss: total 16.9%, 23.4%; excess 57.5%, 66.0%; BMI reduction was 6.2 and 9.1 kg/m 2 . Satisfaction questionnaire (6 months): 100.0% would recommend the procedure. Preliminary findings suggested that SG-revisional MagGI was technically feasible and achieved a promising excess weight loss of 66.0%. Longer-term follow-up in larger cohorts is needed to establish safety and efficacy.