Magnetic compression simplifies revisional sleeve gastrectomy

The preliminary findings from a multi-centre study assessing magnetic gastroileostomy bipartition (MagGI procedure) as a revisional option for suboptimal sleeve gastrectomy (SG), suggest that SG-revisional MagGI was technically feasible and achieved promising excess weight loss of 66.0%.

Self-aligning GT Metabolic MagDI System magnets fused together

The study was conducted in adults (body mass index [BMI, kg/m2] ≥30.0–≤50.0). The 90-day primary feasibility endpoint was magnet placement (≥90% of cases), magnet passage without reintervention, and patent anastomosis creation. Secondary outcomes included weight reduction and improved metabolic indicators.

The MagDI System is composed of the GT Metabolic linear DI magnets, the GT Metabolic delivery system, and the GT Metabolic laparoscopic positioning device (LPD). During the MagDI procedure two linear magnets are delivered orogastrically to the patient. After one magnet was delivered endoscopically to the ileum, and another magnet to the gastric antrum, magnets were laparoscopically approximated to initiate gradual compression anastomosis.

The anastomosis created with magnet compressions happens without the cutting or piercing of intestinal tissue that occurs with the current practice of stapling or suturing. The MagDI System is designed for more consistent tissue alignment, central necrosis, and circumferential healing while leaving no foreign materials behind to impede the natural tissue healing process.

Between November 2023 and July 2024, 20 enrolled patients (mean age 46.1 years, BMI 37.1 ± 0.8, weight 101.0 ± 3.0 kg) underwent SG-revisional MagGI. The researchers reported that there was 100% magnet placement, a median passage of 31 days and patent anastomosis was confirmed in all cases. They reported that 80% (47/59) of adverse events were low grade (Clavien-Dindo I-II). Two intestinal tears (grade III) due to bowel forceps were repaired and resolved; 4 grade-IV SAEs occurred, none were related to the magnet device. There was no instances of anastomotic leak, bleeding or mortality.

Six-months (n=17) and 12-month (n=7) total weight loss was 16.9% and 23.4%, with excess weight loss totalling 57.5% and 66.0%. In addition, BMI reduction was 6.2 and 9.1 kg/m2, , and all patients noted they would recommend the procedure in a follow up questionnaire.

Despite these positive initial results, the researchers cautioned that longer-term follow-up with larger patient numbers are needed to establish safety and efficacy.

The findings were reported in the paper, ‘Linear Magnetic Compression Gastroileostomy Bipartition (MagGI): Feasibility and Early Outcomes’, published in the Journal of the American College of Surgeons. To access this paper, please click here (log-in maybe required)