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Sutureless Duodeno-Ileal Anastomosis with Self-Assembling Magnets: Safety and Feasibility of a Novel Metabolic Procedure

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Abstract

Background

Less invasive and safer anastomotic techniques are desirable. We aimed to determine technical feasibility and safety of sutureless duodeno-ileal side-to-side anastomosis in obese patients using self-assembling magnets.

Methods

This was an open-label, prospective, and single-arm study including obese patients (BMI 30–50 kg/m2) with type II diabetes. The ileal magnet was deployed laparoscopically, and the duodenal magnet was deployed endoscopically. Both magnets were coupled under laparoscopic and fluoroscopic guidance. The primary endpoints were technical feasibility and safety. The secondary endpoints were patency of the anastomosis, HbA1c reduction, and weight loss 12 months after the procedure.

Results

A total of 8 patients were enrolled in the study; median age was 51.5 years (range: 34–65), and median BMI was 38.8 kg/m2 (range: 35–47.9). The mean procedural duration was 63.5 min (range: 41–95). No intraoperative complications were recorded, and no major postoperative morbidity related to the procedure occurred. Magnets were expelled at a median of 29.5 days after the procedure with no associated complications. Upper endoscopy at 12 months confirmed patent anastomoses with healthy-appearing mucosa in all patients. HbA1c reduced below 7.0% in 6 out of 8 (75%) patients, and greater than 5% of total body weight loss was observed in 7 out of 8 (87.5%) patients at 12 months.

Conclusions

Sutureless duodeno-ileal side-to-side anastomosis using self-assembling magnets is feasible and safe in obese patients, and a dual-path enteral diversion with large-caliber and durable anastomosis can be achieved.

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Author information

Authors and Affiliations

  1. Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredón 1640 (ATT 1118), Buenos Aires, Argentina

    Francisco Schlottmann & Rudolf Buxhoeveden

  2. Brigham and Women’s Hospital, Boston, MA, USA

    Marvin Ryou & Christopher C. Thompson

  3. Emerson Hospital, Concord, MA, USA

    David Lautz

Authors
  1. Francisco Schlottmann
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  2. Marvin Ryou
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  3. David Lautz
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  4. Christopher C. Thompson
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  5. Rudolf Buxhoeveden
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Corresponding author

Correspondence to Francisco Schlottmann.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Francisco Schlottmann has no conflicts of interest or financial ties to disclose. Marvin Ryou has financial ties with GI Windows (consulting fees). David Lautz has financial ties with GI Windows (consulting fees and stock options). Christopher C. Thompson has financial ties with GI Windows (consulting fees and stock options). Rudolf Buxhoeveden has no conflicts of interest or financial ties to disclose.

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Key Points

• Sutureless duodeno-ileal side-to-side anastomosis using self-assembling magnets is feasible and safe in obese patients.

• Once the anastomosis has formed, the mated magnet complex breaks free into the enteral flow and is excreted in the patient’s stool.

• The procedure creates a dual-path enteral diversion in which both the diversion and “native” routes remain patent.

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Schlottmann, F., Ryou, M., Lautz, D. et al. Sutureless Duodeno-Ileal Anastomosis with Self-Assembling Magnets: Safety and Feasibility of a Novel Metabolic Procedure. OBES SURG 31, 4195–4202 (2021). https://doi.org/10.1007/s11695-021-05554-z

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  • DOI: https://doi.org/10.1007/s11695-021-05554-z

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