Magnetic Gastrointestinal Universal Septotome: First Results Of A Pilot Study in Esophageal Epiphrenic Diverticulum

Aims In absence of motility disorders, treatment of symptomatic epiphrenic esophageal diverticulum (EED) is challenging. We have developed a specific device which provides marsupialization of EED after placement of two magnets on each sides of the septum of the diverticulum, linked by a self retractable suture wire, called MAGUS (Magnetic Gastrointestinal Universal Septotome). Once inserted, magnets and self-retractable surgical wire induce a progressive ischemia, leading to tissue necrosis and ultimately its section. We initiated a prospective human study to evaluate technical success, clinical outcome and safety following MAGUS insertion in patient presenting with symptomatic diverticulum.

Methods Insertion procedures were done under general anesthesia. MAGUS delivery system is advanced over a guidewire in the esophagus. Under endoscopic guidance proximal magnet is mobilized inside the diverticulum and placed at the bottom of it. Under fluoroscopic guidance the distal magnet is pulled on the esophageal side at the level of the proximal intradiverticular magnet until magnetic apposition occurs. Clinical outcome were followed prospectively.

Results During September and october2020, two men of 73 and 56 years old displaying symptomatic EED were enrolled. Diverticulum and septum sizes measure 52.5 and 21.5 mm in the first one and 58 and 32 mm in the second patient. Technical implantation was successful in both. Device insertion time took 12 and 15 minutes. No clinical adverse event related to the procedure was observed. The magnets migrated spontaneously in the first patient and required an additional endoscopy for retrieval in the second one. One month after insertion, Eckardt score dropped from 2 to 1 and from 6 to 2 respectively.

Conclusions Marsupialization of EED using MAGUS system seems to be safe and effective in the two first patients included in a pilot trial, allowing to consider that MAGUS could become one of the endoscopic treatment of symptomatic EED.

Citation: Huberland F, Delattre C, Cauche N et al. OP208 MAGNETIC GASTROINTESTINAL UNIVERSAL SEPTOTOME: FIRST RESULTS OF A PILOT STUDY IN ESOPHAGEAL EPIPHRENIC DIVERTICULUM. Endoscopy 2021; 53: S86.

Publication History

Article published online:
19 March 2021