Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results
Adult
Male
Obesity; Sleeve gastrectomy
Duodenum
Gastric Bypass
Magnetic compression anastomosis
32 Ciencias Médicas
Gastrectomy
Weight Loss
617
Humans
Obesity
Sleeve gastrectomy
Chirurgie
Retrospective Studies
2. Zero hunger
Duodeno-ileostomy
Anastomosis, Surgical
Magnet system
Type 2 diabetes
3. Good health
Obesity, Morbid
2023 SAGES Oral
Ciencias Biomédicas
Diabetes Mellitus, Type 2
Metabolic/bariatric surgery
Magnets
Female
DOI:
10.1007/s00464-023-10134-6
Publication Date:
2023-05-22T17:02:59Z
AUTHORS (14)
ABSTRACT
Abstract
Introduction
Gastrointestinal anastomoses with classical sutures and/or metal staples have resulted in significant bleeding and leak rates. This multi-site study evaluated the feasibility, safety, and preliminary effectiveness of a novel linear magnetic compression anastomosis device, the Magnet System (MS), to form a side-to-side duodeno-ileostomy (DI) diversion for weight loss and type 2 diabetes (T2D) resolution.
Methods
In patients with class II and III obesity (body mass index [BMI, kg/m2] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two linear MS magnets were delivered endoscopically to the duodenum and ileum with laparoscopic assistance and aligned, initiating DI; sleeve gastrectomy (SG) was added. There were no bowel incisions or retained sutures/staples. Fused magnets were expelled naturally. Adverse events (AEs) were graded by Clavien-Dindo Classification (CDC).
Results
Between November 22, 2021 and July 18, 2022, 24 patients (83.3% female, mean ± SEM weight 121.9 ± 3.3 kg, BMI 44.4 ± 0.8) in three centers underwent magnetic DI. Magnets were expelled at a median 48.5 days. Respective mean BMI, total weight loss, and excess weight loss at 6 months (n = 24): 32.0 ± 0.8, 28.1 ± 1.0%, and 66.2 ± 3.4%; at 12 months (n = 5), 29.3 ± 1.5, 34.0 ± 1.4%, and 80.2 ± 6.6%. Group mean respective mean HbA1C and glucose levels dropped to 1.1 ± 0.4% and 24.8 ± 6.6 mg/dL (6 months); 2.0 ± 1.1% and 53.8 ± 6.3 mg/dL (12 months). There were 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, or mortality.
Conclusion
In a multi-center study, side-to-side Magnet System duodeno-ileostomy with SG in adults with class III obesity appeared feasible, safe, and effective for weight loss and T2D resolution in the short term.
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CITATIONS (12)
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