Marcos Berry, MD1, Lionel Urrutia, MD1, Maria Jose Dominguez, MD1, Matthew Kroh, MD2. 1Bariatric Surgery Unit, Clinica Las Condes, Santiago, Chile, 2Cleveland Clinic, Cleveland, USA
1. Objective of the technology
The Magnetic Surgical System (Levita Magnetics Corp) is an innovative technological platform that uses magnetic fields to enhance mobilization and exposure during surgery. The system allows for un-constrained, shaft-less magnetic retraction and mobilization of organs that overcomes the current limitations of conventional laparoscopic instruments. The Magnetic Surgical System increases the range of motion for traction during the procedure, as the instrument is not limited by the entry point. Also, the system is capable of being repositioned under direct visualization, changing the angle of traction for optimal view. It is an excellent and efficient solution for diminishing the invasiveness and increases the safety.
2. Description of the technology
The system is comprised of an internal magnetic grasper with a detachable tip and an external magnetic controller. The grasper is designed in a similar shape and function as a regular laparoscopic grasper, 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 magnet is placed over the abdominal wall and a magnetic attraction is achieved. The external magnet can then be freely moved providing unconstrained retraction. At the end of the procedure, the detachable grasper tip is reconnected to the magnetic grasper shaft and removed from the patient.
3. Preliminary results
The Magnetic Surgical System is cleared for commercialization in Europe (CE Mark) and it is commercially available in Chile for any laparoscopic procedure. The objective of this study was to analyze the clinical performance in the first clinical cases using the Magnetic Surgical System in a sleeve gastrectomy technique using less number of ports.
The group was composed of 23 patients (16 women and 7 men) with an average of 35.8 years old (range 17-62) and BMI average of 33.4 Kg/m2 (range 30-38.3). All of them had comorbidities related to obesity.
All the procedures were fully performed by a reduced port technique (3 ports instead of 5; one umbilical and one in each flank). The Magnetic Surgical System was used to make traction of the greater omentum to perform the dissection of the greater curvature and then to mobilize and expose the stomach to securely apply the stapler lines. The device enables an efficient exposure of the stomach for the gastric section and stapling that increase the safety of the procedure. The mean operative time was 98 minutes (range 50-138). There were no complications or side effects related to the device. In the post-operatory, one patient presented abdominal wall bleeding in the right flank incision that was resolved with an external stitch. No other patient presented any other complications.
This study shows that the Magnetic Surgical System enhances Sleeve Gastrectomy surgery as it diminishes the number of incisions and enhances exposure for gastric section and stapling. The system reduces invasiveness and increases safety, maximizing the benefits for the patients. Additional clinical evaluations in other minimally invasive surgical procedures should be considered in order to continue to evaluate the system’s benefit.