112 - Magnetic Compression Anastomosis - Tips, Tricks and Techniques

Discuss indications, technical details, and strategies for successful magnetic compression anastomosis in the biliary, gastrointestinal and urinary tracts. This is illustrated with the aid of cases completed at our institution.

Materials and Methods:

Retrospective review of our center approved by the institution’s IRB identified 8 patients presenting with strictures which failed prior interventional treatment attempts done by interventional radiology. Identified patients were: Three patients with esophageal strictures as a result of head and neck radiation treatment, three patients post liver transplantation with occlusive stricture at the hepatojejunostomy anastomosis, one patient post Whipple’s procedure with occlusive stricture at the hepatojejunostomy anastomosis and one patient post radical cystectomy and ileal conduit creation with occlusive stricture at the distal uretero-ileal anastomosis. This educational exhibit focuses on the review of procedural details, helping guide future operators with magnet selection, patient selection and setup optimization. Additionally, by reviewing cases of repeat occlusion experienced at our institution following initial successful recanalization, we discuss follow-up and post-MCA angioplasty recommendations while comparing our strategies to previously published work.

Results:

All procedures were technically successful (100%). All patients were scheduled for magnet retrieval 2-4 weeks post procedure with mean time being 17.8 days. Successful creation of anastomosis in all cases (100%), proven with documented passage of contrast agents between two previously occluded structures (esophago-gastric, hepato-jejunal, uretero-ileal). No intra procedural or delayed procedural complications were reported. Mean follow up time was 781 days.

Conclusion:

Magnetic compression anastomosis is a safe revolutionary minimally invasive technique with great technical success that should be considered as a minimally invasive option for treating occlusive benign strictures. General methodology is similar in all cases, thus allowing for cross-over learning and exploration of possible new applications.