Magnetic duodeno-ileostomy

What is a MagDI?

The MagDI is a procedure designed to support weight-loss and metabolic health. It creates a side to side connection, called an anastomosis, between the upper and lower small intestine, this connection is formed using a pair of magnets. Over the course of 2 to 3 weeks, the magnets bring the bowel walls together, allowing the tissue between them to gently fuse and create a smooth and stable pathway that allows some of the food to pass through. Once the new opening has fully formed, the magnets are passed through the intestines naturally.and are eliminated in the stool.

The MagDI may be considered for adults whose BMI indicates obesity, are living with obesity and/or diabetes that remains difficult to control with medical therapy, and want a less invasive option than traditional bypass surgery. It can be offered to people who have not had weight-loss surgery before and suffer from type 2 diabetes refractory to medical therapy, but it is especially helpful for those who previously had sleeve surgery and are now experiencing issues such as weight regain, insufficient weight loss or acid reflux. By redirecting some of the food from the top to the bottom part of the intestines, the procedure activates a strong natural hormone response in the body, which can support weight loss and improve conditions like type 2 diabetes and high cholesterol. Since the connection is created with magnets rather than cutting or stapling the bowel, it involves less potential complications than classic weight-loss bypass surgery. (Gagner et al, 2022)

The MagDI procedure happens in two steps on the same day.- First, the patient swallows a small magnet. After a few hours, an X-ray confirms that it has reached the lower small intestine. If the position is correct, the patient proceeds to the operating room, where the first magnet is repositioned laparoscopically and a second magnet is placed using a gastroscope. The surgeon brings together the two magnets. The two magnets lock together through the bowel walls, and softly compress over time (roughly 2-3 weeks) to form a new connection, without cutting or stapling the bowel. The maturation of this connection is monitored with follow-up X-ray imaging.

^REFERENCES

^{Gagner, M., Cadiere, G. B., Sanchez-Pernaute, A., Abuladze, D., Krinke, T., Buchwald, J. N., Van Sante, N., Van Gossum, M., Dziakova, J., Koiava, L., Odovic, M., Poras, M., Almutlaq, L., & Torres, A. J. (2023). Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results. Surgical endoscopy, 37(8), 6452–6463. https://doi.org/10.1007/s00464-023-10134-6
Gagner, M., Almutlaq, L., Cadiere, G. B., Torres, A. J., Sanchez-Pernaute, A., Buchwald, J. N., & Abuladze, D. (2024). Side-to-side magnetic duodeno-ileostomy in adults with severe obesity with or without type 2 diabetes: early outcomes with prior or concurrent sleeve gastrectomy. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 20(4), 341–352. https://doi.org/10.1016/j.soard.2023.10.018
Biertho, L., Marceau, S., Nadeau, M., Lebel, S., Julien, F., Tchernof, A., Ransom, T., Spence, R. T., & Ellesmere, J. (2025). Magnetic duodenoileal anastomosis with sleeve gastrectomy: a prospective multicenter study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 21(2), 166–174. https://doi.org/10.1016/j.soard.2024.10.020}