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Background <p>Single-anastomosis duodenal-ileal bypass and duodeno-ileal bipartition are effective metabolic surgeries but remain technically demanding due to the complexity and risk of duodeno-ileal anastomotic leaks. Magnetic compression anastomosis using Self-Forming Magnets (SFM) offers a simplified, sutureless alternative that may reduce procedural risk. This study evaluated the feasibility, safety, and four-year outcomes of the SFM Sutureless Neodymium Anastomosis Procedure (SNAP) in patients with obesity and type 2 diabetes mellitus (T2DM).</p> Methods <p>This prospective, single-center study included patients with obesity and T2DM. The SNAP technique involved endoscopic and laparoscopic deployment of SFMs to create a duodeno-ileal anastomosis without sutures or staples. Primary endpoint was change in hemoglobin A1c (HbA1c) through 48 months. Secondary endpoints included percent total weight loss (%TWL) and safety outcomes.</p> Results <p>Fourteen patients (age 48 ± 9 years; 50% female; baseline BMI 40.4 ± 3.7&#xa0;kg/m²) underwent successful SNAP creation (technical success 100%). Mean procedural time was 68 ± 20&#xa0;min. No intraprocedural adverse events occurred. Follow-up rates were 93%, 86%, 57%, and 50% at 12, 24, 36, and 48 months, respectively. HbA1c significantly decreased from 8.3 ± 1.3% to 6.4 ± 0.6%, 6.6 ± 1.2%, 6.4 ± 1.5%, and 6.9 ± 1.8% at 12, 24, 36, and 48 months, respectively (all <i>p</i> &lt; 0.05). Corresponding %TWL was 13.4 ± 8.6%, 14.2 ± 11.5%, 15.6 ± 13.6%, and 13.5 ± 12.9%.</p> Conclusions <p>SFM-assisted duodeno-ileal bipartition using the SNAP technique appears safe and effective, with sustained weight loss and glycemic improvement over four years. This magnet-based, sutureless approach may represent a less invasive alternative to conventional duodeno-ileal anastomosis in metabolic surgery.</p>

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Four-Year Outcomes of Duodeno-Ileal Bipartition Using Self-Forming Magnets: The Sutureless Neodymium Anastomosis Procedure (SNAP) for Obesity and Type 2 Diabetes

  • 期刊论文

  • 发表日期：

    2026年5月20日

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  • Pichamol Jirapinyo,
  • Francisco Schlottmann,
  • David B. Lautz,
  • Patrick Ryou,
  • Marvin Ryou,
  • Christopher C. Thompson,
  • Rudolf Buxhoeveden

摘要

Background

Single-anastomosis duodenal-ileal bypass and duodeno-ileal bipartition are effective metabolic surgeries but remain technically demanding due to the complexity and risk of duodeno-ileal anastomotic leaks. Magnetic compression anastomosis using Self-Forming Magnets (SFM) offers a simplified, sutureless alternative that may reduce procedural risk. This study evaluated the feasibility, safety, and four-year outcomes of the SFM Sutureless Neodymium Anastomosis Procedure (SNAP) in patients with obesity and type 2 diabetes mellitus (T2DM).

Methods

This prospective, single-center study included patients with obesity and T2DM. The SNAP technique involved endoscopic and laparoscopic deployment of SFMs to create a duodeno-ileal anastomosis without sutures or staples. Primary endpoint was change in hemoglobin A1c (HbA1c) through 48 months. Secondary endpoints included percent total weight loss (%TWL) and safety outcomes.

Results

Fourteen patients (age 48 ± 9 years; 50% female; baseline BMI 40.4 ± 3.7 kg/m²) underwent successful SNAP creation (technical success 100%). Mean procedural time was 68 ± 20 min. No intraprocedural adverse events occurred. Follow-up rates were 93%, 86%, 57%, and 50% at 12, 24, 36, and 48 months, respectively. HbA1c significantly decreased from 8.3 ± 1.3% to 6.4 ± 0.6%, 6.6 ± 1.2%, 6.4 ± 1.5%, and 6.9 ± 1.8% at 12, 24, 36, and 48 months, respectively (all p < 0.05). Corresponding %TWL was 13.4 ± 8.6%, 14.2 ± 11.5%, 15.6 ± 13.6%, and 13.5 ± 12.9%.

Conclusions

SFM-assisted duodeno-ileal bipartition using the SNAP technique appears safe and effective, with sustained weight loss and glycemic improvement over four years. This magnet-based, sutureless approach may represent a less invasive alternative to conventional duodeno-ileal anastomosis in metabolic surgery.