The principles and practice of magnetic instrumentation for natural orifice transluminal endoscopic surgery and other limited access surgical operations

Abstract

Natural orifice transluminal endoscopic surgery (NOTES) is viewed as a means of breaking one of the physical barriers associated with invasive abdominal operation by decoupling body wall injury from the surgical intervention. However, although the global concept has been clearly elucidated, there remains many separate components that still need piecing together before its routine practice can be realized. In particular, NOTES, in common with other confined access approaches such as single-port laparoscopic surgery, imposes marked constraints on the range and fluidity of operator instrument movement. Therefore, at present, these techniques possess significant limitations on their capacity for ensuring sufficient instrument triangulation as well as the appropriate degrees of tissue positioning and tensioning for facilitating efficient dissection. These technical considerations have recently reinvigorated the investigation of the utility of magnets in affecting surgical operation. The majority of work to date has however focused solely on permanent magnets due to their ease of manufacture and handling, despite the significant limitations inherent in their physical qualities. This review considers these issues and presents the potential engineering solution achievable by employing high-temperature superconducting electromagnets to impose the required physical forces for effective surgical operation in place of conventional rigid assistance instrumentation.

Modeling of a compliant joint in a Magnetic Levitation System for an endoscopic camera

“…5). Given the geometry and the properties of the EPMs, considering the average human abdominal wall thickness as 30 mm (Song, 2006) and in order to satisfy the MAGS main technical requirements (Cahill, 2009), two commercially available (KJ Magnetics, Jamison US) cylindrical (6.35 mm in diameter and 12.7 mm in length) magnets (NdFeB, N52) were embedded in the tail. A long longitudinal hole in the frame body allowed the wires to run through the module.…”