Magnetic Anastomosis for Glycemic Insulin Control (MAGIC): A Pilot Study of Minimally Invasive (Endoscopic/Laparoscopic) Side-to-Side Duodeno-Distal Ileal Anastomosis in Pigs
Final rept. 1 Nov 2012-17 Oct 2013
DAVID GRANT USAF MEDICAL CENTER TRAVIS AFB CA 60TH MEDICAL GROUP
Pagination or Media Count:
MAGIC Magnetic Anti-Glycemic Ileal Conduit I Jejunal-Ileal Magnetic Compression Anastomosis Corrects Insulin Resistance in Diabetic Pigs. PURPOSE Bariatric surgery corrects insulin resistance independent of weight loss, possibly through enterokine signaling pathways. We hypothesize that a Magnetic Anti-Glycemic Ileal Conduit MAGIC anastomosis created with magnetic compression between the proximal jejunem and distal ileum corrects insulin resistance. METHODS Yucatan mini pigs n 12 received a high fat diet for 3 months to induce insulin resistance. Animals were randomly assigned to 4 groups n3. Baseline intravenous glucose tolerance tests IVGTT were performed in fat-fed pigs and one pig as a control. Eight animals underwent the MAGIC procedure using either 23 mm n3 or 17 mm diameter n5 magnets. Four animals underwent sham operation. Groups were survived for 2, 4, 8 or 12 weeks, at which points IVGTTs were repeated to assess changes in insulin sensitivity. Plasma glucose and serum insulin by ELISA was measured n8. Animals were euthanized and the anastomosis procured for histology. RESULTS Baseline insulin resistance was confirmed in fat-fed pigs versus control Insulin area under the curve normalized to weight AUC 0.330 0.206 vs 0.053, p .005. Insulin sensitivity improved by 2 weeks in animals after MAGIC treatment compared with sham AUC 0.169 0.098 vs 0.382 0.30, p 0.005. While animals with 23 mm magnets experienced excessive weight loss 25 observed by 4 weeks, this was ameliorated in pigs with 17 mm magnets 48 3 vs 18 14. No anastomotic leaks or strictures were observed in any animals. All animals took liquids on the day of surgery and were tolerating solids on POD. Two animals had diarrhea that abated, but none required supplements or TPN.
- Anatomy and Physiology
- Medicine and Medical Research
- Electricity and Magnetism