Magnet assisted laparoscopic surgery: first Indian experience

Abstract

Background: The problems associated with shaft-based instrumentation include restricted manoeuvrability, restricted visibility and sword fighting of instruments. One of the easiest solutions is to reduce the number of working ports. A unique approach is by the use of a natural force of nature i.e.; magnetism. In this study, we have tried to incorporate the properties of magnetism and magnetic substances to the advantage of surgeons and hence, patients.Methods: The magnet employed in our study is a 3500 Gauss magnet, of 15×10 cm which was placed over the anterior abdominal wall in a sterile manner. The magnet was moved along the anterior abdominal wall in order to manipulate and mobilize intra-abdominal tissue. Laparoscopic bull dog clamps as well as B. P. handles were used intra-peritoneally to grasp tissue, which in turn are mobilised by the magnet. The end point evaluated was of safety and feasibility to adequately mobilize and manipulate organs to achieve effective exposure for dissection.Results: In total, we have successfully completed 15 surgical procedures using magnet assisted tool. Eight patients underwent magnet assisted laparoscopic appendectomy. three patients underwent magnet assisted laparoscopic cholecystectomy. Four patients underwent magnet assisted mesh repair for ventral hernias. None of the patients developed magnet related complications.Conclusions: Magnet assisted laparoscopic surgery is feasible and easy to use. The cost can be minimal. This is a new concept that is here to stay and will become integrated into many other forms in the future. In the rapidly evolving world of surgery, with invasiveness of surgery on the downward trend, magnetism may be the answer to the next leap in surgery: non-invasive surgery.