Magnetic Anastomosis for Glycemic Insulin Control (MAGIC): A Pilot Study of Minimally Invasive (Endoscopic/Laparoscopic) Side-to-Side Duodeno-Distal Ileal Anastomosis in Pigs
Abstract
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 (n=3). 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 (n=3) or 17 mm diameter (n=5) 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 (n=8). 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.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 08, 2013
- Accession Number
- ADA608130
Entities
People
- C. W. Iqbal
- D. A. Kwiat
- E. J. Leeflang
- Hilary Gallogly
- Kullada Pichakron
- Michael Harrison
Organizations
- David Grant USAF Medical Center