New Technology

Surgical Endoscopy

, Volume 23, Issue 7, pp 1660-1666

First online:

Retraction and triangulation with neodymium magnetic forceps for single-port laparoscopic cholecystectomy

  • Guillermo DominguezAffiliated withGastrointestinal Surgery Division, Department of Surgery, Hospital de Clínicas, Buenos Aires University Email author 
  • , Luis DurandAffiliated withGastrointestinal Surgery Division, Department of Surgery, Hospital de Clínicas, Buenos Aires UniversityGastrointestinal Surgery Division, Department of Surgery, Hospital de Clínicas, Buenos Aires University Email author 
  • , Julián De RosaAffiliated withIMANLAP Project, Tesla Medical Devices Co
  • , Eduardo DanguiseAffiliated withGastrointestinal Surgery Division, Department of Surgery, Hospital de Clínicas, Buenos Aires University
  • , Carlos ArozamenaAffiliated withGastrointestinal Surgery Division, Department of Surgery, Hospital de Clínicas, Buenos Aires University
  • , Pedro A. FerrainaAffiliated withDepartment of Surgery, Hospital de Clínicas, Buenos Aires University

Abstract

Introduction

There have been attempts to minimize the invasiveness of laparoscopic cholecystectomy by reducing the size and/or the number of the operating ports and instruments. These attempts create technical challenges related principally to retraction and triangulation necessary to expose the surgical field for a safe surgery. A new technique based on retraction and triangulation with magnetic instruments for single port laparoscopic surgery is presented.

Methods

Between March 2007 and December 2008, 40 laparoscopic cholecystectomies were performed with single-port laparoscopic surgery with the assistance of magnetic forceps (IMANLAP™ project). The surgical technique is described, and the intraoperative and postoperative course of the patients is assessed.

Results

There were no intraoperative complications, no need to convert to open surgery, and no need to add a second port. Depending on the patient’s anatomy, a 1-mm needle was added in some cases. There were no interactions observed between the magnetic devices and the anesthetic monitoring and the rest of the devices of the operation room.

Conclusions

This new procedure is feasible and safe. The main goal is control of the magnetic field, allowing enough controlled strength for retraction and sufficient triangulation for adequate exposure of the surgical field. This allows for the use of a single port through which an optic device with a working channel can perform the operation with safety. Finally, the procedure can be performed in a manner similar to the traditional laparoscopic cholecystectomy, and it also appears to be simple to learn.

Keywords

Magnetic retraction Magnetic triangulation Single port Laparoscopy Cholecystectomy