Complex pediatric laparoscopic procedures
A redesigned prototype is being manufactured for preclinical testing.
Magnetically activated device to manipulate organs and tissue during laparoscopic surgery
Single Incision Laparoscopic Surgery (SILS) is rapidly replacing multiple incision laparoscopic surgery for increasingly complex procedures (e.g., cholecystectomy, bowel reconstruction). At present, a limiting factor is the inability to manipulate the operative field of dissection without using an instrument that passes through the abdominal wall.
We have developed a system for placing sterile hermetically sealed rare earth magnets through a single umbilical port, positioning the device on or around any organ, and then manipulating the position of the organ using a second sterile magnet on the outside of the abdomen.
The string of magnets is flexible, and flexibility can be adjusted by varying the magnetic spheres and cylinders (i.e., an ‘all sphere configuration’ is most flexible; ‘all cylinders’ is least flexible, and ‘alternating sphere-cylinder’ is intermediate). This allows manipulation of each end from outside the body with another strong magnet. The polarity is arranged so that each end of the string would be held up to the inside of the abdominal wall by magnetic force applied from the outside. Each end of the string is held to a different place in the abdominal wall by a second magnet of opposite polarity. The string can then be used to retract or hold any organ to the underside of the body wall. The beauty of the magnetic arrangement is that the two external magnets, arranged with opposite polarity, can be manipulated from outside the body to provide any degree of tension for fixation.
The second part of the invention is the arrangement of the two external magnets to maximize the magnetic field strength going into the body and minimize it on the outside so that it will not interfere with other instruments. This is achieved by putting a permeable metal between the two outside magnets, creating an “adjustable horseshoe” magnet. This is made adjustable by a hinge or hinges in that permeable metal that allow the two magnets to essentially be in any configuration.
We are currently developing animal experiments to test the validity of the design and manipulative ability. We are also working to develop the tools that can be placed through one of the ports to control the placement of the device. We have applied for SBIR funding from the NIH to support the early development of this device.