Magnetic compression anastomosis in gastrointestinal and biliary disease: Techniques and clinical applications

Table 5 Summary of clinical studies evaluating magnetic compression anastomosis for intestinal and colorectal conditions

Ref.	Country	Design and patients	Indication	Main outcome	Adverse events and limitations
Graves et al[13], 2017	United States	Prospective single-center first-in-human pilot study; n = 5	Small bowel anastomosis during open reconstructive surgery	Formation of functional small bowel anastomosis without leak, bleeding, or stricture. Clinical success: 5/5 (100%); technical success: 5/5 (100%)	No anastomosis-related complications; unrelated complications included aspiration pneumonia, internal hernia, Clostridium difficile infection, and superficial surgical site infection
Kamada et al[63], 2021	Japan	Retrospective single-center case series; n = 14	Gastrointestinal obstruction (without general anesthesia)	Creation of functional gastrointestinal anastomosis to relieve obstruction. Clinical success: 11/14 (78.6%); technical success: 14/14 (100%)	Restenosis (n = 2); anastomotic perforation due to balloon dilation (n = 1)
Gagner et al[64], 2023	Georgia	Prospective first-in-human observational study; n = 5	Side-to-side magnetic compression duodeno-ileostomy with sleeve gastrectomy for obesity and type 2 diabetes	Successful creation of patent duodeno-ileal anastomosis with magnet expulsion without reintervention. Clinical success: 5/5 (100%); technical success: 5/5 (100%)	No device-related adverse events; mild abdominal wound pain (n = 3), mucosal tear during endoscopy (n = 1), intra-abdominal hematoma (n = 1), ileal serosal tear (n = 1)
Gagner et al[65], 2023	Belgium, Spain, Georgia	Prospective multicenter observational study; n = 24	Side-to-side magnetic duodeno-ileostomy with sleeve gastrectomy for obesity and type 2 diabetes	Successful magnet placement with formation of patent duodeno-ileal anastomosis and spontaneous magnet expulsion. Clinical success: 24/24 (100%); technical success: 24/24 (100%)	3 procedure-related serious adverse events; no device-related adverse events, no anastomotic leak, bleeding, obstruction, infection, or mortality
Cadière et al[66], 2024	Belgium	Prospective observational study; n = 10	Side-to-side duodeno-ileal bipartition with sleeve gastrectomy	Patent duodeno-ileal anastomosis confirmed endoscopically at 1 year. Clinical success: 9/9 evaluated (100%); technical success: 10/10 (100%)	Serosal tears (n = 2), sleeve leak (n = 1), dehydration (n = 3), internal hernia (n = 1); no device-related AEs
Gagner et al[22], 2025	Canada, Belgium, Spain, Georgia	Prospective multicenter study; n = 43	Side-to-side magnetic duodeno-ileostomy with or without sleeve gastrectomy for severe obesity	Successful magnet positioning, formation of patent duodeno-ileal anastomosis, and spontaneous magnet passage. Clinical success: 43/43 (100%); technical success: 43/43 (100%)	No device-related adverse events, leaks, bleeding, obstruction, infection, or death
Gagner et al[67], 2024	Belgium	Prospective single-center study; n = 24	Revisional side-to-side magnetic duodeno-ileostomy after sleeve gastrectomy for severe obesity	Formation of patent duodeno-ileal anastomosis with spontaneous magnet expulsion and no need for reintervention. Clinical success: 24/24 (100%); technical success: 24/24 (100%)	8 SAEs (Clavien-Dindo II-III) but none related to device or procedure; no leak, bleeding, obstruction, infection, or death
Gagner et al[68], 2024	Belgium	Prospective single-center first-in-human study; n = 7	Gastroileostomy for revision of sleeve gastrectomy	Successful placement and alignment of magnets with patent gastroileal anastomosis and spontaneous magnet expulsion. Clinical success: 7/7 (100%); technical success: 7/7 (100%)	3 serious adverse events (Clavien-Dindo III anal fissure/hemorrhoids in 1 patient); no device-related adverse events, leaks, bleeding, obstruction, infection, or death
Gagner et al[69], 2025	Czech Republic	Prospective first-in-human observational study; n = 9	Jejuno-ileostomy bipartition for obesity and type 2 diabetes	Successful magnet alignment and formation of patent jejuno-ileal anastomosis with spontaneous magnet expulsion. Clinical success: 9/9 (100%); technical success: 9/9 (100%)	No severe adverse events; minor events included influenza after discharge and transient hypoglycemia after magnet expulsion
Bhandari et al[70], 2026	India, Chile	Prospective multicenter study; n = 14	Jejuno-jejunal anastomosis in Roux-en-Y gastric bypass	Freedom from anastomotic adverse events within 30 days. Clinical success: 14/14 (100%); technical success: 14/14 (100%)	Procedure-related AEs: Bleeding, dysphagia, pulmonary embolism, diabetic ketoacidosis (n = 4); no device-related AEs
Machytka et al[57], 2017	Czech Republic	Prospective single center study; n = 10	Partial jejunal diversion	Total weight loss. Clinical success: 100%; technical success: 100%	No Serious, trocar-related gastric injury in one patient

AE: Adverse event; SAE: Serious adverse event.