Magnetic Duodeno Ileal Bypass for Metabolic Syndrome in Rhesus Monkeys

Project Summary Abstract Type diabetes mellitus T DM associated with obesity can now be successfully treated by bariatric surgery The metabolic effect is rapid in part independent of the effect on weight loss and mediated by gut factors We are exploring the possibility that this beneficial effect on T DM can be achieved without major surgery by creating a small side to side magnetic compression anastomosis between the duodenum and the ileum Magnetic Duodenal Ileal Bypass or DIPASS Our preliminary data in mini pigs suggest that by diverting a small amount of digestive juices gastric biliary pancreatic to the ileal mucosa this intestinal short cut is able to mimic the beneficial metabolic and hormonal effect of bypass surgeries on glucose metabolism This proposal will test the feasibility of inserting the intestinal short cut DIPASS in a non human primate model of metabolic syndrome the efficacy of the DIPASS procedure versus sham operation on improving metabolism and the mechanism by which DIPASS exerts its effect on glucose metabolism We will also collect a unique biobank of tissue samples that will allow further studies to assess the molecular mechanism by which the procedure exerts its effect DIPASS can be accomplished minimally invasively as an outpatient procedure using our previously developed magnetic anastomosis device Magnamosis and newly developed trans oral delivery devices that enable an incisionless procedure Data generated from this proposal will have direct translational application and will enable us to develop future studies in humans Project Narrative Type diabetes is a major public health problem approaching epidemic proportions in the U S and globally Growing evidence shows that type diabetes may be successfully treated by obesity surgery This project aims to demonstrate the feasibility and efficacy of reversing type diabetes through a novel minimally invasive outpatient surgical procedure utilizing some of the aspects of obesity surgery However our procedure is not a replacement bariatric surgery but rather a short procedure that repositions a portion of the small intestine causing a reversal of certain elements that contribute to type diabetes It is in no way intended to treat obesity