Endolumenal Anastomosis Creation with Magnets

Objective: Creation of a safe endolumenal gastro-jejunal anastomosis with neodymium magnets.
Background: This paper describes a new technique for performing an endolumenal gastro-jejunal anastomosis using neodymium magnets.
Methods: An experimental survival study was conducted in seven swine with open translumenal placement of variable shaped magnets in the stomach and jejunum. An anastomosis was created between magnets in the stomach and jejunum due to ischemia and necrosis of the underlying trapped tissues. After a week, the animals were sacrificed in a sterile fashion and the anastomoses were tested using direct gastroscopic evaluation with air insufflation test. Specimens were resected and reviewed microscopically.
Results: Five of five ring shaped magnets resulted in complete anastomoses. Two non-fenestrated magnet approximations revealed the presence of a thin transparent intact membrane, or some preserved tissue between the stomach and jejunum on endoscopic examination and on pathology; full anastomoses were not observed in these cases. The five complete anastomoses were secure with negative leak tests. Despite an uncomplicated post-operative course, a marginal ulcer and adhesions were observed near the anastomosis in one animal using large ring magnets.
Conclusion: Gastro-jejunal anastomoses using ring-shaped magnets are feasible and superior to other magnet configurations. These concepts may provide a platform for investigators to develop purely endolumenal anastomosis in the future.

Session: Podium Presentation

Program Number: P193

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