The use of magnets with single-site umbilical laparoscopic surgery

Padilla, Benjamin E.; Domı́nguez, Gema; Millán, Carolina; Martinez-Ferro, Marcelo

doi:10.1053/j.sempedsurg.2011.05.007

Cited by 38 publications

(23 citation statements)

References 16 publications

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“…2,3 Prior experience with magnetic-assisted laparoscopic surgery in adult and pediatric population has shown the safety, feasibility, and efficacy of this surgical technique. 7 In that experience, the adjunctive use of magnets enabled us either to reduce the number of ports needed or to perform transumbilical surgery. Our group first performed magnetic-assisted TUC with two magnets in both pediatric and adult patients, but it was cumbersome because of the potential for magnet collision, and we felt it was too complex to gain widespread adoption.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Recent reports from our group have examined the feasibility and safety of magnet-assisted transumbilical surgery in a range of operations, showing adequate triangulation and effective retraction of target organs. [5][6][7] Still, this novel technique during TUC requires the use of two magnets, which increases procedural complexity, chiefly because of the risk of magnet collision (especially in the pediatric population). In an effort to further simplify the procedure, we modified our approach with magnet-assisted TUC using a hybrid technique with only one magnet and a curve grasper.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Novel Hybrid (Magnet Plus Curve Grasper) Technique During Transumbilical Cholecystectomy: Initial Experience of a Promising Approach

Millán¹,

Bignon²,

Bellia³

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel Hybrid (Magnet Plus Curve Grasper) Technique During Transumbilical Cholecystectomy: Initial Experience of a Promising Approach

Millán¹,

Bignon²,

Bellia³

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Suction cups [19] or fan-shaped levers [3] can be adopted in this case. On the other hand, traumatic graspers (e.g., crocodile jaws) are a viable solution if the surgeon plans to remove the retracted tissue at the end of the procedure (e.g., cholecystectomy) [4].…”

Section: Safetymentioning

confidence: 99%

“…Magnetic surgical instruments developed to date include cameras [3], retractors [4], dissectors [3], and cautery devices [5], with trials performed on animal and human models via singleincision access [6].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Tissue Retractor Based on Local Magnetic Actuation

Garbin

Natali

Buzzi

et al. 2015

Journal of Medical Devices

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Magnetic instruments for laparoscopic surgery have the potential to enhance triangulation and reduce invasiveness, as they can be rearranged inside the abdominal cavity and do not need a dedicated port during the procedure. Onboard actuators can be used to achieve a controlled and repeatable motion at the interface with the tissue. However, actuators that can fit through a single laparoscopic incision are very limited in power and do not allow performance of surgical tasks such as lifting an organ. In this study, we present a tissue retractor based on local magnetic actuation (LMA). This approach combines two pairs of magnets, one providing anchoring and the other transferring motion to an internal mechanism connected to a retracting lever. Design requirements were derived from clinical considerations, while finite element simulations and static modeling were used to select the permanent magnets, set the mechanism parameters, and predict the lifting and supporting capabilities of the tissue retractor. A three-tier validation was performed to assess the functionality of the device. First, the retracting performance was investigated via a benchtop experiment, by connecting an increasing load to the lever until failure occurred, and repeating this test for different intermagnetic distances. Then, the feasibility of liver resection was studied with an ex vivo experiment, using porcine hepatic tissue. Finally, the usability and the safety of the device were tested in vivo on an anesthetized porcine model. The developed retractor is 154???mm long, 12.5???mm in diameter, and weights 39.16???g. When abdominal wall thickness is 2???cm, the retractor is able to lift more than ten times its own weight. The model is able to predict the performance with a relative error of 9.06???±???0.52%. Liver retraction trials demonstrate that the device can be inserted via laparoscopic access, does not require a dedicated port, and can perform organ retraction. The main limitation is the reduced mobility due to the length of the device. In designing robotic instrument for laparoscopic surgery, LMA can enable the transfer of a larger amount of mechanical power than what is possible to achieve by embedding actuators on board. This study shows the feasibility of implementing a tissue retractor based on this approach and provides an illustration of the main steps that should be followed in designing a LMA laparoscopic instrument

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“…Kume et al demonstrated porcine laparoscopic cholecystectomy [13] and colonic resection [14] with the aid of magnetic retraction. The Hospital de Clínicas in Buenos Aires has reported the clinical use of magnetized instruments (NdFeB) for single site laparoscopy [15], [16]. Clinical investigation of single-port laparoscopic colectomy was demonstrated to be safe and effective with the aid of magnetic retraction by Uematsa et al [17] while single site laparoscopy investigations by Cho et al have been limited to canine ileocecectomy (resection of the lower small intestine) [18].…”

Section: A Clinical Backgroundmentioning

confidence: 99%

Electropermanent Magnetic Anchoring for Surgery and Endoscopy

Tugwell

Brennan

O’Shea

et al. 2015

IEEE Trans. Biomed. Eng.

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This article has been accepted for publication in a future issue of this journal, but has not been fully edited. Content may change prior to final publication. Citation information: DOI 10.1109/TBME.2014.2366032, IEEE Transactions on Biomedical Engineering TBME-00722-2014.R2 1Abstract-The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet off when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a centre lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

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The use of magnets with single-site umbilical laparoscopic surgery

Cited by 38 publications

References 16 publications

Novel Hybrid (Magnet Plus Curve Grasper) Technique During Transumbilical Cholecystectomy: Initial Experience of a Promising Approach

Novel Hybrid (Magnet Plus Curve Grasper) Technique During Transumbilical Cholecystectomy: Initial Experience of a Promising Approach

Laparoscopic Tissue Retractor Based on Local Magnetic Actuation

Electropermanent Magnetic Anchoring for Surgery and Endoscopy

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