Summa Health’s Weight Management Institute has performed thousands of bariatric procedures over the years to help patients lose weight and improve the quality of their lives.
These surgeries typically involve stapling and incisions, which lead to patient soreness and a couple of weeks of recovery time.
A new piece of technology was recently developed to eliminate the need for incisions and increase patient safety and comfort in bariatric surgeries. In January, Summa Health became the first hospital in Ohio to use the tool, GT Metabolic Solutions’ MagDI System, in a weight-loss procedure known as a Side-to-Side Compression Anastomosis Duodeno-ileostomy.
“When opportunities like this come up to improve the care that we provide patients and to add another tool … to combat this very prevalent and complex disease, I get excited about it,” said Dr. Adrian Dan, medical director of Summa Health’s Weight Management Institute, who performed the surgery.
Magnets allow surgeons to form a connection within the small intestine
The new technology uses magnets developed by Dr. Michel Gagner, a bariatric surgeon in Canada and co-founder of GT Metabolic Solutions, using neodymium, a rare earth metal.
Gagner was also the first surgeon to perform the laparoscopic sleeve gastrectomy, a minimally invasive procedure that involves dividing the stomach into two separate parts so patients can eat less to feel full.
Since its FDA approval in 2024, nearly 40 centers in the U.S. are offering the procedure, said Marcus Voss, vice president of sales for the U.S. at GT Metabolic Solutions.
Voss said the magnets allow surgeons to perform an anastomosis, or connection, between two parts of the small intestine, the duodenum and the ileum, without making an incision in the GI tract.
This connection allows food to bypass part of the small intestine, resulting in reduced nutrient absorption as well as hormonal changes that help patients to lose weight.
Insurance coverage for the procedure varies by plan.
Trevor Paisley, a 50-year-old Massillon resident, underwent the first Ohio procedure. He lost 12 pounds during his first month post-procedure, and he said it was much less invasive than the previous laparoscopic sleeve gastrectomy he underwent in 2021.
“Personally, I would have no qualms about doing this again or recommending it to anyone,” Paisley said. “I feel good now.”
How does the procedure work?
Dan, who performed Paisley’s surgery alongside Dr. Logan Mellert, a bariatric surgeon, said a magnetic duodeno-ileostomy uses two magnets.
The most common way to perform the procedure is to first have the patient swallow the first magnet two hours before the procedure. It passes through the stomach into a portion of the small bowel. The surgeon then finds it and uses a magnetic instrument to move it to the desired location.
The second magnet is placed by an endoscopist into the duodenum, the first part of the small intestine, and the two magnets click together.
“Over a period of about three weeks, it remodels that area and allows a full connection to be made, utilizing the body’s own healing mechanisms to create this connection, and then the magnets just pass through the intestines and are eliminated naturally,” Dan said.
The procedure is easily reversible if necessary — such as if a patient ends up losing more weight than necessary or is having malabsorption issues — with a single staple firing to split the channels up again, Voss said.
So far, Dan said, the operation results have seen about a 15% total body weight loss as well as improvements in Type 2 diabetes. However, people can lose more.
Which patients are candidates for this surgery?
Patients who require a less invasive approach are candidates for this surgery, Dan said. It’s also considered for patients who have Type 2 diabetes that is difficult to control with medical therapy or who have had a laparoscopic sleeve gastrectomy and are either regaining weight or not losing enough.
Paisley said he decided to undergo this new surgery because he wanted to lose more weight after his first procedure.
He said when he found out about how the magnets work, he felt excited and not nervous.
“When I had a patient who had the right profile for this type of operation and to use this type of technology, I wanted to jump at the opportunity to provide that for them,” Dan said.
Paisley said he went home the same day of the procedure, which was on a Friday. He was back to work on Monday.
“After the surgery part, you’re getting back to normal a lot quicker than the first time around,” he said. “I was able to get up and move around quicker, and I didn’t have any soreness, even just sitting around, like I had from the first surgery.”
He felt that this surgery was much less invasive than his first one. After his laparoscopic sleeve gastrectomy in 2021, he had to stay two nights in the hospital and had four or five staples placed in different parts of his stomach.
“Anytime you have a connection between two pieces of bowel that is made with division of the bowel and reconnection using staples or sutures, there’s the potential that those could fail,” Dan said. “In this situation, the two magnets just click together, and we can make these connections without making any incisions into the GI tract.”
Paisley said this time around, there were fewer instructions he had to follow post-operation.
“Not that the first one was horrible, but this one was just so much simpler in what they were looking to do, which I think is the whole concept of this surgery,” he said.
How does the procedure help patients lose weight?
Paisley’s goal is to lose 100 pounds post-procedure. So far, he said while eating meals, he feels full significantly quicker and isn’t as hungry.
“Even just last night, having dinner, what I would have had in even just a normal meal, I couldn’t even eat,” he said in a March 5 interview. “I’m eating much less, and I feel full quicker, so it definitely has a very positive effect on the amount of food you can even eat.”
Dan said patients will feel fuller quicker because of the bypass created during surgery. It also evokes hormonal responses to increase certain hormones, including GLP-1.
“When people eat, it delivers the food that people eat to that portion of the small bowel faster,” he said. “Instead of taking a pill or an injection to get GLP-1, your own body provides … your own naturally made GLP-1 and other hormones.”
He said metabolism improves, becoming closer to what someone without obesity has in their body’s ability to process calories.
“By improving your metabolism, you’re able to live a normal lifestyle and eat normally with good eating habits, but see the pounds melting away,” Dan said.
The procedure also improves pancreatic function, blood pressure and overall health, along with decreasing cardiac risk factors.
GLP-1 medicines vs. bariatric surgery
When it comes to GLP-1-based medicines, they don’t have the same magnitude of weight loss as bariatric operations provide, said Vance Albaugh, spokesperson for The Obesity Society and a surgeon and scientist at Pennington Biomedical Research Center at Louisiana State University.
In clinical trials, GLP-1 medicines have led to 15% to 20% total weight loss. But if a patient stops taking the medicine, the weight will come back, meaning they have to stay on it for the rest of their lives.
Albaugh said a sleeve gastrectomy results in about 25% total body weight loss after two years, and a gastric bypass results in about 30% to 35% total body weight loss after a couple of years.
Richard Peterson, president of the American Society for Metabolic and Bariatric Surgery and chief of metabolic and bariatric surgery at UT Health San Antonio, said the main trigger he sees for patients deciding to undergo surgery is improving their health and quality of life.
“We’re, as surgeons, oftentimes seeing patients who’ve already done all of the things as they get there,” he said. “I’ve been doing this for over 20 years, and I can only think of one patient who ever came to me who had not already tried all of the things — lifestyle and medications, things like that — before they wanted to do surgery.”
GLP-1 medicines have risen in popularity because of their high advertising budget, he said. They’re much more visible now, but they can be hard to get because of insurance issues, supply problems and their cost.
Surgery is the most durable option of all the treatments, he said.
A multidisciplinary approach to obesity
Dan said he wishes more people knew that obesity is a disease.
“Primary care doctors still tell their patients, ‘You need to go on a diet, and you need to get a treadmill,’ and we know that in patients with that serious of a condition, that doesn’t work. It just doesn’t,” he said. “It’s not willpower, it’s not an act of choice or behavior, it’s not about discipline. It’s about a metabolic dysfunction.”
He said there is a multidisciplinary approach to treating obesity, including options for surgery, medication and behavioral therapy.
“We try to meet people where they are,” Albaugh said. “Not everybody wants to take medicine, just like not everybody wants to undergo a surgical procedure.”
Peterson said a lot of people come to bariatric surgeons feeling defeated and like nobody has listened to them.
“There’s a lot of misinformation about obesity, medical treatment, obesity surgical treatment,” Albaugh said. “Weight has this stigma and this idea that people have kind of done this to themselves, and there’s a lot of bias, and there’s a lot of blame.”
Dan said he is excited to have another tool to treat obesity.
“I just wish that more people would see obesity in that light as a complex, chronic, progressive disease, which is also, by the way, treatable,” he said. “And that’s what we’re here for.”
Lauren Cohen is a community reporting intern for the Akron Beacon Journal and Signal Akron. The position is funded through a grant from the Knight Foundation, which is a financial supporter of Signal Akron.
