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Dr. Michel Gagner (Canada) and his team at the Westmount Square Surgical Center (Canada) will perform a Magnetic Jejuno-Ileostomy (MagJI) for Weight Regain Post Gastric Bypass and answer all your questions.
Clinical Background
A 34-year-old woman, weighing 189 lb and measuring 5' 3" in height (BMI 33.5 kg/m²) at the time of consultation, has type 2 diabetes treated with dapagliflozin and a prior trial of tirzepatide.
She underwent Roux-en-Y gastric bypass in 2014.
Her preoperative weight was 240 lb (BMI 42.5 kg/m²), with a postoperative nadir of 128 lb (BMI 22.7 kg/m²), followed by a weight regain of 61 lb.
Technique Description
The procedure to be demonstrated is a Laparoscopic-Endoscopic Assisted Magnetic Jejuno-Ileostomy (MagJI). This technique is presented as a minimally invasive, non-stapled revisional option for treating weight regain and type 2 diabetes in patients with prior Roux-en-Y Gastric Bypass, creating a side-to-side anastomosis through magnetic compression to enhance malabsorption and metabolic signaling.
Procedure Steps
Laparoscopic Access & Identification: Mapping of the previous Roux-en-Y anatomy and measurement of bowel limbs.
Proximal Magnet Delivery: Endoscopic placement of the first magnet into the jejunal Roux limb.
Distal Magnet Delivery: Laparoscopic placement of the second magnet into the distal ileum.
Magnetic Coupling: Alignment and "clicking" of magnets to create side-to-side serosal apposition.
Seromuscular Fixation: Security suturing and mesenteric closure to prevent internal hernia.
Spontaneous Anastomosis: Ischemic tissue fusion and natural evacuation of magnets.
Training Objectives
Understand the principle of distalisation
Review recent literature on the subject
Present technical details of side-to-side magnetic jejuno-ileostomy
