Magnetic Compression May Simplify Revisional Sleeve Gastrectomy, Reduce Morbidity

Gagner Michel, Almutlaq, Ribeiro R, et al. Linear Magnetic Compression Gastroileostomy Bipartition (MagGI): Feasibility and Early Outcomes. J Am Coll Surg. March 2026

A multisite 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. 

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. There was 100% magnet placement, a median passage of 31 days, and patent anastomosis confirmed in all cases. 

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, with none related to the magnet device. There was no anastomotic leak, bleeding, or mortality.

Respective 6- (n = 17) and 12- (n = 7) month total weight loss was 16.9% and 23.4%, with excess weight loss totaling 57.5% and 66.0%. BMI reduction was 6.2 and 9.1 kg/m2, respectively, and all patients noted they would recommend the procedure in a follow up questionnaire.

Preliminary findings suggested that SG-revisional MagGI was technically feasible and achieved promising excess weight loss. While longer-term follow-up in larger cohorts is needed to establish safety and efficacy, surgeons who perform revisional for suboptimal SG are encouraged to keep apprised of developments in this potentially less morbid approach.