Fellow Leads Study on Innovative MagDI Bipartition for Safe, Effective Weight and T2D Reduction

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.

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 HbA1_C.

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 HbA1_C 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.

Access to JACS is a free benefit of ACS membership. Read the full article.