LAPAROSCOPIC JEJUNO-ILEAL BYPASS WITH TWO SWALLOWED LINEAR MAGNETS gagner.michel@gmail.com

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LAPAROSCOPIC JEJUNO-ILEAL BYPASS WITH TWO SWALLOWED LINEAR MAGNETS

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Canada

Video

Minimally invasive surgery may be further advanced with the novel biofragmentable magnetic anastomosis compression system. Two magnets may be swallowed, or placed by flexible endoscopy, in a side-to-side magnetic jejuno-ileostomy (MagJI) bipartition for weight and type 2 diabetes (T2D) reduction. MagJI markedly reduces the major complications of enterotomy, stapling/suturing, and retained foreign materials.

This video describes the technical aspects of a prospective first-in-human investigation of feasibility, safety, and preliminary efficacy in adults with body mass index (BMI, kg/m2) ≥30.0–≤40.0. After serial introduction via swallowing or endoscopy, linear magnets were laparoscopically guided to the distal ileum and proximal jejunum, where they were aligned. Magnets fused over 7-21 days, forming a jejuno-ileostomy.

Between 3-1-2024 and 6-30-2024, nine patients (mean BMI 37.3±1.1) with T2D (all on T2D medications; mean HbA1C 7.1±0.2 %, glucose 144.8±14.3 mg/dL) underwent MagJI. Mean procedure time: both magnets swallowed, 86.7±6.3 min; one magnet swallowed with second delivered endoscopically, 113.3±17.0 min. Ninety-day feasibility confirmed in 100.0%: 0.0% bleeding, leakage, infection, mortality. Most AEs grade I-II; no SAEs. At 6-month radiologic confirmation, all anastomoses were patent. Excess weight loss 17.5±2.8 kg; mean BMI reduction 2.2±0.3, HbA1C 6.1±0.1% (p<0.01), glucose 115.5±6.5 mg/dL (p=0.19); 83.0% dropped below 6.5% HbA1C and had markedly reduced anti-T2D medications.

The swallowable, biofragmentable magnetic anastomosis system appeared to be feasible and safe in achieving incisionless, sutureless jejuno-ileostomy. The first-in-human MagJI procedure may offer minimally complicated anastomosis creation and moderate MBS weight loss and T2D reduction.

https://vimeo.com/1110690223/fd379d9708