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An application research on a novel internal grasper platform and magnetic anchoring guide system (MAGS) in laparoscopic surgery

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Abstract

Background

Laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery attempt to reduce transabdominal port sites. These require all instruments to pass through a single access point, leading to instruments collide or work at unfamiliar angles. Thus, we designed an internal grasper under magnetic anchoring guide system (MAGS) platform and investigated its utility and operability.

Methods

We measured the configuration for magnetic force decay over distance using a standardized, ex vivo laboratory testing apparatus. An electronic balance was used to measure the force of the gallbladder pull in ten patients with gallbladder stones. One pig (11 mm abdominal wall thickness) underwent a compressed trial of MAGS platform. The device was left in place for 20 min before tissue sections were harvested, and histologic assessment was performed. The utility and operability were investigated in four pigs (38–280 kg weight).

Results

The magnetic attraction force decayed exponentially over distance; the force of pulling gallbladder was 7.46 ± 0.54 N. This pairing of components allowed for coupling to a theoretical distance of 10 mm. No gross tissue damage was observed. H–E stain showed no necrosis in all specimens. One failed due to wall thickness of 45 mm. Others showed the critical view, triangulation of instruments was obtained, and instrument collision or “sword fighting” was reduced.

Conclusions

The MAGS platform overcomes limitations such as collisions and lack of triangulation, reduces transabdominal port sites, and is easy to operate. However, our internal grasper requires the abdominal wall thickness below 10 mm.

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References

  1. Haber GP, Autorino R, Laydner H, Yang B, White MA, Hillyer S, Altunrende F, Khanna R, Spana G, Wahib I, Fareed K, Stein RJ, Kaouk JH (2012) SPIDER surgical system for urologic procedures with laparoendoscopic single-site surgery: from initial laboratory experience to first clinical application. Eur Urol 61:415–422

    Article  PubMed  Google Scholar 

  2. Park S, Bergs RA, Eberhart R, Baker L, Fernandez R, Cadeddu JA (2007) Trocar-less instrumentation for laparoscopy: magnetic positioning of intra-abdominal camera and retractor. Ann Surg 245:379–384

    Article  PubMed  PubMed Central  Google Scholar 

  3. Zeltser IS, Bergs R, Fernandez R, Baker L, Eberhart R, Cadeddu JA (2007) Single trocar laparoscopic nephrectomy using magnetic anchoring and guidance system in the porcine model. J Urol 178:288–291

    Article  PubMed  Google Scholar 

  4. Scott DJ, Tang SJ, Fernandez R, Bergs R, Goova MT, Zeltser I, Kehdy FJ, Cadeddu JA (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21:2308–2316

    Article  PubMed  Google Scholar 

  5. Scott D, Tang S, Goova M, Bergs R, Hogg D, Kehdy F, Cadeddu J, Fernandez R (2007) Short-term survival outcomes following transvaginal NOTES cholecystectomy using magnetically anchored instruments. Gastrointest Endosc 65:AB109

    Article  Google Scholar 

  6. Scott D, Tang S, Goova M, Bergs R, Kehdy F, Hogg D, Hollett L, Olukoga C, Gedeon M, Cadeddu J (2008) Optimizing magnetically anchored camera, light source, graspers, and cautery dissector for transvaginal NOTES cholecystectomy. Surg Endosc 22:S244

    Article  Google Scholar 

  7. Scott DJ, Tang SJ, Bergs R, Olukoga CO, Paramo J, Hogg DC, Fernandez R (2008) Transvaginal single access “pure” NOTES sleeve gastrectomy using a deployable magnetically anchored video camera. Gastrointest Endosc 67:AB116–AB117

    Article  Google Scholar 

  8. Raman JD, Scott DJ, Cadeddu JA (2009) Role of magnetic anchors during laparoendoscopic single site surgery and NOTES. J Endourol 23:781–786

    Article  PubMed  Google Scholar 

  9. Cadeddu J, Fernandez R, Desai M, Bergs R, Tracy C, Tang S-J, Rao P, Desai M, Scott D (2009) Novel magnetically guided intra-abdominal camera to facilitate laparoendoscopic single-site surgery: initial human experience. Surg Endosc 23:1894–1899

    Article  PubMed  Google Scholar 

  10. Raman JD, Bergs RA, Fernandez R, Bagrodia A, Scott DJ, Tang SJ, Pearle MS, Cadeddu JA (2009) Complete transvaginal NOTES nephrectomy using magnetically anchored instrumentation. J Endourol 23:367–371

    Article  PubMed  Google Scholar 

  11. Mashaud LB, Kabbani W, Caban A, Best S, Hogg DC, Cadeddu JA, Bergs R, Beardsley H, Fernandez R, Scott DJ (2011) Tissue compression analysis for magnetically anchored cautery dissector during single-site laparoscopic cholecystectomy. J Gastrointest Surg 15:902–907

    Article  PubMed  Google Scholar 

  12. Arain NA, Cadeddu JA, Best SL, Roshek T, Chang V, Hogg DC, Bergs R, Fernandez R, Webb EM, Scott DJ (2012) A randomized comparison of laparoscopic, magnetically anchored, and flexible endoscopic cameras in performance and workload between laparoscopic and single-incision surgery. Surg Endosc 26:1170–1180

    Article  PubMed  Google Scholar 

  13. Mashaud LB, Kabbani W, Caban A, Best S, Hogg DC, Cadeddu JA, Bergs R, Beardsley H, Fernandez R, Scott DJ (2011) Tissue compression analysis for magnetically anchored cautery dissector during single-site laparoscopic cholecystectomy. J Gastrointest Surg 15:902–907

    Article  PubMed  Google Scholar 

  14. Joseph RA, Salas NA, Donovan MA, Reardon PR, Bass BL, Dunkin BJ (2012) Single-site laparoscopic (SSL) cholecystectomy in human cadavers using a novel percutaneous instrument platform and a magnetic anchoring and guidance system (MAGS): reestablishing the “critical view”. Surg Endosc 26:149–153

    Article  PubMed  Google Scholar 

  15. Best SL, Bergs R, Gedeon M, Paramo J, Fernandez R, Cadeddu JA, Scott DJ (2011) Maximizing coupling strength of magnetically anchored surgical instruments: how thick can we go? Surg Endosc 25:153–159

    Article  PubMed  Google Scholar 

  16. Best SL, Kabbani W, Scott DJ, Bergs R, Beardsley H, Fernandez R, Mashaud LB, Cadeddu JA (2011) Magnetic anchoring and guidance system instrumentation for laparo-endoscopic single-site surgery/natural orifice transluminal endoscopic surgery: lack of histologic damage after prolonged magnetic coupling across the abdominal wall. Urology 77:243–247

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by a grant from the Ministry of Education Innovation Team Development Program of China (No. IRT1279, YL) and a grant from the Shaanxi Province science and technology resource integrated program (No. 2016TZC-G-5-6, RW).

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, Shaanxi, China

    Yafei Shang, Da Zhang, Fei Xue, Xiaopeng Yan, Aihua Shi, Dinghui Dong, Shanpei Wang, Feng Ma, Haohua Wang, Jianhui Li, Xuemin Liu, Rongqian Wu & Yi Lv

  2. Department of General Surgery, Xi’an Central Hospital, Xi’an, Shaanxi, China

    Yafei Shang & Da Zhang

  3. Department of General Surgery, Xi’an Hospital of Traditional Chinese Medicine, Xi’an, Shaanxi, China

    Hongjun Guo

  4. Department of Surgical Oncology, Shaanxi Province People’s Hospital, Xi’an, Shaanxi, China

    Jianhui Li

  5. Northwest Nonferrous Metal Research Institute, Xi’an, Shaanxi, China

    Ruixue Luo

Authors
  1. Yafei Shang
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  2. Hongjun Guo
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  3. Da Zhang
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  4. Fei Xue
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  5. Xiaopeng Yan
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  6. Aihua Shi
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  7. Dinghui Dong
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  8. Shanpei Wang
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  9. Feng Ma
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  10. Haohua Wang
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  11. Jianhui Li
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  12. Xuemin Liu
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  13. Ruixue Luo
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  14. Rongqian Wu
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  15. Yi Lv
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Corresponding author

Correspondence to Yi Lv.

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Disclosures

Yafei Shang, Hongjun Guo, Da Zhang, Fei Xue, Xiaopeng Yan, Aihua Shi, Dinghui Dong, Shanpei Wang, Feng Ma, Haohua Wang, Jianhui Li, Xuemin Liu, Ruixue Luo, Rongqian Wu, Yi Lv declared that they have no conflict of interest.

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Shang, Y., Guo, H., Zhang, D. et al. An application research on a novel internal grasper platform and magnetic anchoring guide system (MAGS) in laparoscopic surgery. Surg Endosc 31, 274–280 (2017). https://doi.org/10.1007/s00464-016-4968-9

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  • DOI: https://doi.org/10.1007/s00464-016-4968-9

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