Linear Magnetic Compression Gastroileostomy Bipartition (MagGI): Feasibility and Early Outcomes

Michel Gagner; Lamees Almutlaq; Rui Ribeiro; Gismonde Gnanhoue; Sarifa Vally-Adam; J N Buchwald; Gilberto Couto; Carlos Abril; John Rodriguez

doi:10.1097/XCS.0000000000001926

Linear Magnetic Compression Gastroileostomy Bipartition (MagGI): Feasibility and Early Outcomes

J Am Coll Surg. 2026 Mar 19. doi: 10.1097/XCS.0000000000001926. Online ahead of print.

Authors

Michel Gagner¹, Lamees Almutlaq¹, Rui Ribeiro², Gismonde Gnanhoue¹, Sarifa Vally-Adam¹, J N Buchwald³, Gilberto Couto², Carlos Abril⁴, John Rodriguez⁴

Affiliations

¹ Department of Surgery, Westmount Square Surgical Center, Westmount, QC, Canada.
² Multidisciplinary Ctr. for Obesity Treatment, Hospital Lusíadas Amadora and Lisbon, Portugal.
³ Division of Scientific Research Writing, Medwrite, Maiden Rock, WI.
⁴ Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.

PMID: 41854172
DOI: 10.1097/XCS.0000000000001926

Abstract

Background: Minimally invasive magnetic compression technique may simplify the completion of an anastomosis and reduce major surgical complications by obviating permanent staple/suture fixation and enterotomy closures.

Study design: A multi-site study of magnetic gastroileostomy bipartition (MagGI procedure) as a revisional option for suboptimal sleeve gastrectomy (SG) was conducted in adults (body mass index [BMI, kg/m2] ≥30.0-≤50.0). 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 90-day primary feasibility endpoint was magnet placement (≥90% of cases), magnet passage without reintervention, and patent anastomosis creation. Secondary: weight reduction, improved metabolic indicators.

Results: Between November 6, 2023 and July 10, 2024, 20 enrolled patients (mean age 46.1 years, BMI 37.1±0.8, weight 101.0±3.0 kg) underwent SG-revisional MagGI. Primary feasibility endpoint was met: 100.0% magnet placement, median passage 31.0 days; patent anastomosis confirmed (20/20). 80.0% (47/59) of AEs were low grade (Clavien-Dindo I-II). Two intestinal tears (grade III) due to bowel forceps were repaired and resolved; 4 grade-IV SAEs, none related to the magnet device. No anastomotic leak or bleeding; no mortality. Respective 6- (n=17) and 12- (n=7) month weight loss: total 16.9%, 23.4%; excess 57.5%, 66.0%; BMI reduction 6.2 and 9.1 kg/m2. Satisfaction questionnaire (6 months): 100.0% would recommend the procedure.

Conclusions: Preliminary findings suggested that SG-revisional MagGI was technically feasible and achieved promising excess weight loss of 66.0%. Longer-term follow-up in larger cohorts is needed to establish safety and efficacy.

Keywords: First-in-human; Gastroileostomy; Magnetic compression anastomosis; Metabolic/bariatric surgery; Obesity; Sleeve gastrectomy.