Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results

• DOI: 10.1007/s00464-023-10134-6
• Publication Date: 2023-05-22T17:02:59Z
• Authors: Michel Gagner; Guy-Bernard Cadiere; Andres Sanchez-Pe...; David Abuladze; Todd Krinke; J. N. Buchwald; Nathalie Van Sante; Marc Van Gossum; Jana Dziakova; Levan Koiava; Maja Odovic; Mathilde Poras; Lamees Almutlaq; Antonio J. Torres
• Keywords: Sleeve gastrectomy; Ileostomy; Duodenal switch

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, preliminary effectiveness of a novel linear magnetic compression anastomosis device, Magnet System (MS), to form side-to-side duodeno-ileostomy (DI) diversion for weight loss type 2 diabetes (T2D) resolution. Methods In patients class II III obesity (body mass index [BMI, kg/m ] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two MS magnets were delivered endoscopically duodenum ileum laparoscopic assistance aligned, initiating DI; sleeve gastrectomy (SG) was added. There no bowel incisions or retained sutures/staples. Fused expelled naturally. Adverse events (AEs) graded by Clavien-Dindo Classification (CDC). Results Between November 22, 2021 July 18, 2022, 24 (83.3% female, mean ± SEM 121.9 3.3 kg, BMI 44.4 0.8) three centers underwent DI. Magnets at median 48.5 days. Respective BMI, total loss, excess 6 months (n = 24): 32.0 0.8, 28.1 1.0%, 66.2 3.4%; 12 5), 29.3 1.5, 34.0 1.4%, 80.2 6.6%. Group respective HbA1 C glucose levels dropped 1.1 0.4% 24.8 6.6 mg/dL (6 months); 2.0 1.1% 53.8 6.3 (12 months). 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, mortality. Conclusion multi-center study, SG adults appeared feasible, safe, effective resolution short term.