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Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
Fellow Leads Study on Innovative MagDI Bipartition for Safe, Effective Weight and T2D Reduction
April 1, 2025
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A recent study released as an article in-press in the Journal of the American College of Surgeons (JACS) describes an innovation in technique that could have implications for patients with mild obesity and type 2 diabetes (T2D)—a first-in-human investigation into use of a biofragmentable magnetic anastomosis system (BMAS) to effect magnetic duodeno-ileostomy (MagDI) bipartition.
Intraoperative view of distal BMAS magnet placed in the ileum paired with the proximal BMAS magnet (located approximately 2 cm distal to the pylorus).
Endoscopic views of patent magnetically created duodeno-ileal anastomosis.
The study was led by Michel Gagner, MD, FACS, a bariatric surgeon in Quebec and an innovator in the development of laparoscopic sleeve gastrectomy. It iterates on Dr. Gagner’s own history of novel uses for magnetic anastomosis.
A small group of patients swallowed or had a magnet placed endoscopically, which was guided laparoscopically to the distal ileum; a second magnet was endoscopically positioned in the post-pyloric duodenum. Over 7 to 21 days, the magnets were aligned to fuse into the MagDI.
In an 18-month period, 15 patients with T2D and mild obesity underwent MagDI in a study with primary endpoints of noting feasibility and severe adverse events, and secondary endpoints of reduction of weight and HbA1C.
After the sub-1-hour operation, feasibility at 90 days was confirmed at 100% and no leakage, bleeding, infection, stricture, or mortality, and at 1-year follow up, all anastomoses were patent. In addition, eight patients who continued to follow up for weight and T2D showed excess weight loss of 38.8% and HbA1C reduction of approximately 1.5 percentage points (8.2 to 6.6±0.1%).
These promising results were achieved without gastrointestinal sutures or staples, which can be a source of bleeding and leaks.
This study from Dr. Gagner et al suggests that MagDI is a potentially useful intervention for patients with mild obesity and T2D to achieve improvement in health status in a straightforward, feasible, and safe procedure.
