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25200 Center Ridge Rd, Suite 1100Mag-DI, or magnetic duodenoileostomy, uses the MagDI™ System by GT Metabolic™ to create a new connection in the small intestine using two small magnets rather than surgical cuts, stitches, or staples. Two magnets are positioned on either side of the bowel wall, gently compress the tissue over two to three weeks, and form a smooth, natural passageway that limits calorie absorption. The magnets then pass out of the body on their own, leaving nothing behind. Dr. Linden Karas, MD, FACS is among the first surgeons in Cleveland and Northeast Ohio to offer magnet-assisted bariatric surgery.
What It Is
Nearly every bariatric operation performed today relies on the same two tools to join two segments of bowel: a stapler, or a needle and suture. Magnetic compression anastomosis does the same job a different way. Two magnets are positioned on either side of the bowel wall, and the pressure they exert holds the tissue together while the body forms the opening itself.
The connection that results is called a duodeno-ileostomy, and in a bariatric procedure it is designed to limit how many calories the small intestine absorbs.
No cutting of the bowel
The connection is formed by compression rather than by cutting or piercing small bowel tissue. No staple line, no suture line, and no reported leaks or bleeds at the connection site in early clinical studies.1–4
Nothing left behind
After the anastomosis is formed, the fused magnets detach and are expelled naturally. The system is designed to leave behind no foreign material that could impede the natural tissue healing process.1–4
Works with your anatomy
Because the stomach and intestine are not divided, the technique works with your existing anatomy and may preserve options for additional procedures later, including reversal.
Where it happens
The new passageway is created between the first and second portions of the small intestine, bypassing a length of bowel so that fewer calories are absorbed from what you eat.
Because the stomach itself is never divided or removed for the magnetic connection, Mag-DI can be performed with a native stomach or after a sleeve gastrectomy.
How Does It Work?
These steps describe use of the MagDI™ System for informational purposes only. Your experience may vary based on your specific needs and anatomy. Talk with Dr. Karas about what to expect.
Step 1
Mag-DI can be performed with a native stomach or after a sleeve gastrectomy. Your surgeon starts from the anatomy you have, and nothing about the stomach needs to be divided or removed for the magnetic connection itself.
Step 2
About two hours before your procedure, you will swallow one small MagDI™ System magnet with water. The magnet is about the size of two multivitamins. It can also be placed via a scope if that suits you better. Its position is confirmed with imaging before the procedure begins.
Step 3
The first magnet passes through the stomach into your small intestine. While you are under anesthesia, your surgeon positions a second magnet within your digestive tract using a scope, guided to the intended fusion site.
Step 4
The magnets attract through the bowel walls, holding the tissue in place to form a connection, a magnetic compression anastomosis, between the first and second portion of the small intestine. The procedure is complete, and once you are ready, you are released to go home.
Step 5
The magnets remain in place for two to three weeks, gently compressing the tissue to create a passageway. In bariatric procedures, that new pathway is designed to limit calorie absorption. The magnets are then naturally expelled from your body, leaving behind no magnets.
Inside the procedure
The magnets hold the two segments of bowel against each other. Over two to three weeks the compressed tissue between them remodels, the opening forms, and the magnets fuse together and detach.
In bariatric procedures, the new pathway is designed to limit calorie absorption. The magnets are naturally expelled from your body, leaving behind no magnets.1–4
Potential Benefits
The MagDI™ System may offer a less invasive alternative to other bariatric procedures, with no sutures, no staples, and no reported leaks or bleeds.1–4 Outcomes achieved with the technology in bariatric procedures have been consistent with outcomes achieved using existing devices and may offer a reduced risk of complications.1–4
No magnets left behind
Magnets are naturally expelled after healing is underway.
Reduced risk of leaks or bleeds
No leaks or bleeds at the connection site were reported in early clinical studies.
Minimally invasive
Requires no cutting or piercing of small bowel tissue.
Strong, natural connection
Supports uniform healing and is designed to provide a stronger connection.5
Future flexibility
Works with existing anatomy and may preserve options for additional procedures, including reversal.
Short hospital stay
Patients go home the same day or the following morning, based on surgeon discretion.
For The Clinically Curious
This is an example of a procedure used in clinical trials. Individual experiences may vary based on patient needs and conditions.
Before surgery
The patient swallows the first magnet with water approximately two hours before the procedure. This magnet can also be placed via a scope.
Two hours later
The magnet travels into the stomach and the duodenum and reaches the ligament of Treitz in about two hours. Its position is confirmed with x-ray.
In the operating room
Once the patient is under anesthesia in the OR, a marker is placed in the ileum 250 cm from the ileocecal valve.
Positioning
The laparoscopic positioning device captures the magnet and directs it distally through the jejunal lumen to the marked position in the ileum.
The second magnet
At the same time, the second, proximal magnet is transported by a flexible endoscopic catheter to meet it.
The connection forms
The magnets couple and compress the tissue between them. The anastomosis opens as the compressed tissue remodels.
Weeks later
Food flows through the duodenal lumen and also through the patent anastomosis into the ileal lumen. The anastomosis is extremely durable after three to four weeks.
Candidacy
Magnetic duodenoileostomy is most often considered for patients who want the powerful metabolic effect of an intestinal procedure with less operative complexity, and for patients with significant type 2 diabetes where that metabolic effect matters most. It can be performed with a sleeve gastrectomy, or after a prior sleeve, adding malabsorptive effect without dividing the stomach or bowel.
Candidacy is evaluated one patient at a time. Dr. Karas reviews your BMI, metabolic history, prior operations, reflux symptoms, medications, and goals, then compares Mag-DI honestly against sleeve, bypass, SADI-S, and endoscopic options before recommending anything.
Every patient who has an intestinal procedure commits to lifelong vitamin supplementation and regular lab work, and that commitment is part of the conversation from the first visit.
How It Compares
| Procedure | How the connection is made | Bowel divided? | Metabolic effect | Best suited for |
|---|---|---|---|---|
| Mag-DI | Two magnets compress tissue; body forms the opening | No cutting or piercing of bowel | High, duodeno-ileal bypass of calories | Type 2 diabetes; maximum metabolic benefit |
| Gastric Sleeve | No intestinal connection made | Stomach stapled and partly removed | Moderate, restriction plus hunger hormones | Most patients; BMI 35+ |
| Gastric Bypass | Stapled and sutured anastomoses | Yes, stomach and intestine divided | High, 50+ years of outcome data | Diabetes, reflux, higher BMI |
| SADI-S | Single stapled intestinal connection | Yes, duodenum divided | Highest of any modern operation | BMI 50+; severe diabetes; sleeve revision |
Questions
No. The magnets remain in place for roughly two to three weeks while they gently compress the tissue and the new passageway forms. They then fuse, detach from the duodeno-ileal site, and are expelled naturally from your body. The MagDI™ System is designed to leave behind no foreign material that could impede natural tissue healing.1–4
The magnet is about the size of two multivitamins and is swallowed with water roughly two hours before your procedure, which is enough time for it to travel through the stomach and reach the correct position in the small intestine. Its position is confirmed with imaging before anything else happens. If swallowing it is not right for you, the magnet can also be placed with a scope instead.
Yes. The MagDI™ System by GT Metabolic™ was cleared for use in magnetic compression anastomosis by the U.S. Food and Drug Administration in October 2024.1
Patients typically go home the same day or the following morning, based on surgeon discretion. Once the procedure is complete and you have recovered from anesthesia, you are released to go home; the anastomosis continues to form over the following weeks without anything further being required of you beyond your normal post-operative diet and follow-up.
Yes, and that is the most common application. The magnetic duodeno-ileal connection can be created alongside a sleeve gastrectomy, or as a second-stage procedure for a patient who already has a sleeve and needs additional weight loss or better diabetes control. Early multi-center results have been published for side-to-side magnet anastomosis duodeno-ileostomy with sleeve gastrectomy.2,4
One of the design goals of the technique is future flexibility. Because it works with your existing anatomy rather than dividing the stomach or bowel, it may preserve options for additional procedures later, including reversal. Whether that applies in your case depends on your anatomy and history, which is exactly what your consultation is for.
Yes. Dr. Karas is among the first surgeons in Cleveland and Northeast Ohio to offer magnet-assisted bariatric surgery, with offices in Lyndhurst and Westlake serving patients across the greater Cleveland area. Candidacy is evaluated individually, so the most useful first step is a consultation: if Mag-DI is the right fit, you will already be evaluated and ready, and if another procedure suits you better, you will know that too. Call 216-377-7257 to get started.
Get Started
Tell us a little about yourself and our team will follow up with all-inclusive pricing, your insurance options, and the next available consultation with Dr. Karas. Our Lyndhurst and Westlake offices serve patients from across Cleveland and Northeast Ohio. There is no obligation, and everything you share stays confidential. Financing with easy monthly payments is available through CareCredit and Cherry, and checking your options does not affect your credit score.
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References
MagDI™ and GT Metabolic™ are trademarks of GT Metabolic Solutions, Inc. This page is provided for informational purposes only and is not medical advice. Individual results and experiences vary based on patient needs, anatomy, and conditions. Talk with your health care provider about whether the MagDI™ System is right for you.
Financing Available
Financing is available for bariatric surgery, the Allurion balloon, Mag-DI and the medical weight loss program. Apply online in minutes, get a decision fast, and pay in monthly installments instead of all at once. Checking your options does not affect your credit score.
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Promotional financing on purchases of $200 or more, including no interest if paid in full within the promotional period, plus longer plans with fixed monthly payments on larger amounts. Prequalify online with no effect on your credit score. Accepted at Karas Weight Loss and Wellness.
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Monthly payment plans up to 60 months, with 0% APR for qualifying applicants. Apply in about a minute with a soft credit check that does not affect your score. High approval rates, including for patients who have been turned down for a card before.
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Next Step
You will get all-inclusive pricing, your insurance options, and a consultation with the surgeon who would perform your procedure, usually within about a week.
Limited time
One visit with Dr. Karas covers the surgical options and the medical weight loss program with GLP-1 medication management, at the Lyndhurst or Westlake office, at no charge.
Or call 216.377.7257Free consultation
Free for new patients at both the Lyndhurst and Westlake offices.
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