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New Surgical Technique: Neodymium Magnets Repair Esophageal Defect

December 2021 | Innovation

Operation
Image: iStock/Georgiy Datsenko

Every year, 200-250 babies are born in Germany with a malformation of the esophagus. In this esophageal atresia, no continuous hollow organ develops from the mouth to the stomach, but two separate, so-called “blind sacs”. The esophagus is interrupted, neither food nor saliva can reach the stomach. This is a life-threatening situation for the newborn, who must be artificially fed and operated on as quickly as possible. In the process, the blind sacs are opened and sewn together. Not an easy operation – especially when there is more than five centimeters of space between them. The ends must then first be brought together under tension and joined in a second operation. The strong traction forces can cause scars and constrictions in the esophagus, making further operations necessary; a heavy burden for babies and their parents.

Magnets Bring Separated Esophagus Together

Professor Dr. Oliver Muensterer from the Dr. von Hauner Children’s Hospital at LMU Klinikum and Prof. Michael Harrison from the University of California in San Francisco and their research teams have developed an alternative that is both gentle and innovative. In the procedure, the blind sacs are brought together and sutured using a minimally invasive keyhole technique, but without being opened. Sewing them together causes them to grow so that the tension decreases over the following weeks. Using endoscopes, magnets are inserted into each of the two blind sacs in a second procedure. They have a diameter of eight millimeters, are made of neodymium and are coated with a layer of gold. Due to their curved shape, the magnets compress the tissue between them and dissolve it in one to two weeks. This creates the desired connection between the blind sacs. The surrounding mucosa can continue to grow and heal slowly, reducing the risk of scarring and narrowing. Once a stable, continuous esophagus is formed, the body eliminates the magnets on its own. 

Company sought for commercial production

So far, the method has been successfully used on six newborns in Germany and the U.S., Muensterer told the weekly newspaper “Hallo München”. To establish it and test it in larger studies, the researchers are now looking for a company to manufacture the neodymium magnets commercially. Unfortunately, due to the rarity of esophageal atresia, production is not economically interesting for many companies. However, there are first interested parties.

At the same time, the developers are thinking about other areas of application, because basically the procedure “can be applied to all cavities in the body, including adults,” says Muensterer. So in the future, many more patients could benefit from the gentle new surgical technique using neodymium magnets.

Operation
Image: iStock/Georgiy Datsenko

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