Detection, Manipulation and Removal of Swallowed Magnetic Objects: A New Method and Literature Review

Purpose To describe a novel, radiation-free magnetic manipulation technique for the intraoperative localization and extraction of ingested magnetic foreign bodies during open pediatric surgery and to report our initial clinical results. Methods We developed a standardized three-step technique: 1) Preparation of a sterile manipulator using an ellipsoidal ferrite magnet placed in a glove finger, 2) Intraoperative localization and controlled guidance of the foreign body to a fistula or enterotomy site using the external magnet (with a finger serving as a safety spacer), and 3) Sterile extraction via glove eversion. This technique was applied in four consecutive pediatric patients (aged 9 months to 6 years) who required open surgery due to magnet-related complications (ileus, fistula, internal herniation) between 2020 and 2024. Results The technique was successfully implemented in all four cases. All magnetic foreign bodies were accurately localized and extracted without the need for intraoperative radiography. No iatrogenic intestinal injuries occurred. Oral feeding resumed after a median of 3 days, with a median hospital stay of 8 days. Conclusion Our preliminary experience suggests this magnetic manipulation technique is a safe, effective, and readily applicable method for managing complicated magnet ingestions. It substantially reduces intraoperative radiation exposure and enables controlled, tissue-sparing extraction. This preliminary experience supports its use and warrants further investigation.