Felipe Huidobro1, J Jensen1, D Guerron2, D Portenier2, R Luengas3, J Rodriguez4, M Kroh4. 1Hospital Padre Hurtado, Santiago, Chile, 2Duke University, Durham, NC, USA, 3Clinica Bicentenario, Santiago, Chile, 4Cleveland Clinic, Cleveland, OH, USA
Objective: Surgery is constantly searching for ways to improve procedural outcomes, while also increasing OR efficiency. Magnetic Surgery has been developed to increase the benefits of minimally invasive surgery as this novel technology reduces the invasiveness of procedures. Clinical results showed reduced pain, less complications, less scars and shorter length of hospital stay. Robotic surgery increases the control that the operating surgeon has over the instruments to complete the procedure, but has demonstrated limited clinical benefit to patients.
Levita® Magnetics (San Mateo, CA), has developed the Magnetic Surgical System. This is an innovative technological platform that uses magnetic fields to enhance mobilization and exposure during surgery, meanwhile reducing invasiveness. The system allows for un-constrained, shaft-less magnetic retraction and mobilization of organs, overcoming the limitations of conventional surgical instruments. A first generation, Magnetic-Robotic Controller has been developed as a means to optimize the platform and increase surgeon control. This is the first reported use of a technology of this kind in patients.
Description: The Magnetic Surgical System is comprised of an internal magnetic grasper with a detachable tip and an external magnetic-robotic controller. The grasper is provided with a delivery/retrieval shaft that allows the application of the detachable tip. With the detachable grasper tip secured to the organ, the external magnetic-robotic controller is positioned over the abdominal wall, and a magnetic attraction is achieved. The surgeon operating the magnetic-robotic controller, obtained the desired retraction. At the end of the procedure, the external magnetic-robotic controller is moved away from the patient, releasing the magnetic attraction. The detachable grasper tip is reconnected to the magnetic grasper shaft and removed from the patient.
Preliminary results: The objective of this study was to analyze the initial clinical performance of the Magnetic-Robotic Controller as an enhanced accessory to the Magnetic Surgical System in reduced-port laparoscopic cholecystectomy procedures. Local IRB approval was obtained and all patients signed an informed consent. The study population consisted of 4 patients (all women) with an average age of 28.8 years old (range 21-33 years old) and BMI average of 29.1 Kg/m2 (range 21.1-34.0 Kg/m2). All 4 patients had a diagnosis of cholelithiasis. All procedures were performed by a reduced-port technique (3 ports instead of 4; one umbilical 10mm and two 5mm in each flank).
The Magnetic Surgical System enabled effective and efficient exposure of the gallbladder and critical structures. The mean operative time was 42 minutes (range 35-56 minutes). There were no complications or side effects related to the device. There was no interference with any other OR equipment. All 4 patients were discharged the same day of the procedure. Recovery was uneventful with follow up visits at 7 and 30 days.
Conclusions: This study demonstrates the combination of magnetic and robotic technologies in one integrated system used for the first time in patients. Potential benefits of this system may include reduced invasiveness and increased surgeon control, maximizing the benefits of less invasive surgery for patients This proof-of-concept human study opens new opportunities in the evolution of surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98849
Program Number: ET005
Presentation Session: Emerging Technology Session
Presentation Type: Podium