Alberto Rodriguez-Navarro, MD, Homero Rivas, MD, Ignacio Robles, MD, Alex Escalona, MD, Steven Schwaitzberg, MD. University of Chile, Stanford University, Catholic University of Chile, Cambridge Health Alliance Harvard Medical School, Levita Magnetics.
To evaluate a new magnetic-based device that facilitates reduced-port techniques in laparoscopic surgery.
Description and method of use
A novel magnetic traction system (the Levita Magnetics Grasper) is composed of a deployable grasper, an introduction/retrieval device, and an external magnet. The deployable grasper is mounted on an introduction device, and is easily deployed and attached to the desired organ or target tissue. The introduction device is removed from the patient, leaving the introduction port available for use. With the deployed grasper secured to the organ, the external magnet is placed over the abdominal wall. Adequate retraction and a wide range of mobilization of the organ are easily obtained. At the end of the procedure, retrieval of the deployed grasper is accomplished by inserting the introduction/retrieval device to recouple with the grasper for removal from the body.
The device has been successfully tested in an animal model of reduced port technique of gallbladder surgery. The device was tested in 5 animals (porcine). 4 animals were non-survival (3 with 3 ports, 1 with 2 ports) and 1 animal (3 ports) had a 3-day survival term. In the survival animal, histological analysis of the abdominal wall was performed evaluating the area contacted by the magnetic grasper under magnetic forces (experimental site), the port site (active control) and an area without intervention (passive control). In all cases the gallbladder removal was successfully performed, with adequate exposure, mobilization of the organ and triangulation. The histological analysis of the abdominal wall of the port site showed areas of full thickness necrosis with hemorrhage, inflammation and edema through the skin and body wall musculature consistent with what is seen in conventional port sites. The area contacted by the magnetic grasper showed no significant damage compared to the area without intervention.
Conclusions / future directions
This novel product will enable the reliable performance of reduce port techniques. Levita Magnetic's grasper showed adequate mobilization, exposure and triangulation to perform the surgical procedures with no damage to the abdominal wall. Clinical trials must be conducted to confirm these early promising results in animal models.