Use of magnets in gastrointestinal surgery

Díaz, Ramón; Dávalos, Gerardo; Welsh, Leonard K.; Portenier, Dana; Guerrón, Alfredo D.

doi:10.1007/s00464-019-06718-w

Cited by 28 publications

(21 citation statements)

References 58 publications

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“…Yamanouchi et al [3,4] reported the first use of MCA in the 1990s, and MCA has been performed to treat complications such as obstruction of esophagojejunostomy after total gastrectomy or ileus for patients unsuitable for general anesthesia, stenosis of the bile duct after intraoperative bile duct injury, and stricture of choledochojejunostomy after living donor transplantation [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

et al. 2020

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Background: Magnetic compression anastomosis (MCA) is mainly applied in the gastrointestinal and biliary tracts through a nonsurgical procedure that can create an anastomosis similar to that obtained through surgery. Magnets usually adsorb in the end-to-end direction (end-to-end anastomosis), exert a strong magnetic force and create an anastomosis according to the size of the magnets. Regular endoscopic dilation is required to prevent restenosis when the anastomotic size is small. We report a case in which MCA was successfully used to treat anastomotic stenosis of the sigmoid colon; the magnets adsorbed in the side-to-side direction rather than the end-to-end direction and generated a wide anastomosis in a short time that did not require endoscopic dilation. Case presentation: An 81-year-old woman was admitted to our hospital to treat anastomotic stenosis of the sigmoid colon for closure of transverse colostomy. Two years prior, the Hartmann operation and drainage were performed at other hospitals due to perforated diverticulitis of the sigmoid colon. Obstruction of the sigmoid colostomy occurred, and a transverse colostomy was performed. One year after the first surgery, high anterior resection was performed, but anastomotic stenosis occurred, causing obstruction. MCA was planned because the patient had a history of multiple operations and was expected to have strong adhesions postoperatively. MCA was safely performed, but two magnets were accidently adsorbed in the side-to-side direction. The magnet position could not be changed. The two magnets were expected to move and adsorb in an end-to-end direction naturally due to bowel movements. The magnets that adsorbed in the side-to-side direction dropped from the anus 5 days after treatment, and the anastomosis was observed by colonoscopy. Three ileus tubes were placed from the transverse colostomy beyond the anastomosis to prevent restenosis. Colonoscopy showed that the anastomosis diameter was wider than expected at 14 days after treatment, and endoscopic dilation was not necessary. No complications were observed in this patient's postoperative course. Finally, closure of the patient's colostomy was successfully performed. Conclusions: MCA with side-to-side anastomosis generated a wide anastomosis in a short time.

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Section: Discussionmentioning

confidence: 99%

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

et al. 2020

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“…Compression induces an ischemia-necrosis-scarring cycle, which creates a patent connection in approximately 5 to 10 days. 20,21 This gradual process induces healing with a lower inflammatory reaction when compared to stapled anastomoses. 22 The model of magnetic loop anastomosis used in this study was easy to perform.…”

Section: Discussionmentioning

confidence: 99%

Effects of Warmed and Humidified CO₂ Surgical Site Insufflation in a Novel Experimental Model of Magnetic Compression Colonic Anastomosis

et al. 2020

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Background. Pneumoperitoneum insufflation with warmed and humidified carbon dioxide (WH-CO2) can prevent heat loss and increase tissue oxygenation. We evaluated the impact of localized WH-CO2 insufflation on the anastomotic healing process. Methods. Sixty male Wistar rats were randomized: Group 1 (control, n = 12), Group 2 (cold and dry CO2, CD-CO2, n = 24), and Group 3 (WH-CO2, n = 24). A magnetic compression side-to-side colonic anastomosis was performed under 60-minute local abdominal CO2 flow insufflation. Animal temperature was recorded. IL-1, IL-6, and CRP levels were assessed before and after insufflation and on postoperative day (POD) 7 and POD 10. Endoscopic follow-up was performed on POD 7 and POD 10. A burst pressure (BP) test of the specimen was performed on POD 10, and histopathological analysis was then performed. Metabolomics of the anastomotic site was determined. Results. Seven rats (5 CD-CO2 group, 1 WH-CO2 group, and 1 control group) died during the survival period. Necropsies revealed intestinal occlusions (n = 2). One additional rat from the CD-CO2 group was sacrificed on POD 7 due to intestinal perforation. The postoperative course was uneventful in the remaining cases. There was no difference in BP among the groups. Thermal monitoring confirmed that WH-CO2 insufflation was effective to reduce heat loss. IL-1 levels were statistically and significantly lower on POD 10 in the WH-CO2 group than the CD-CO2 group but not lower than the control group. CRP levels, histopathology, and metabolomics did not show any difference between the 3 groups. Conclusions. WH-CO2 was effective to preserve core temperature. However, it did not improve anastomotic healing.

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“…Magnetic technologies are now applied to surgical instruments, designed to work in tandem with minimally invasive surgery (MIS) to further reduce the invasiveness of procedures 1–3 . The development of new surgical techniques and novel technologies has resulted in lessened surgical trauma and improvement of patient outcomes including; reduced pain, less complications, less scars, shorter length of hospital stay, faster recovery period and better rate of patient acceptance 4 . Recently, device development and technique modification have focused to reduce the number and size of surgical instruments required to perform common procedures.…”

Section: Introductionmentioning

confidence: 99%

First in‐human experience with a novel robotic platform and Magnetic Surgery System

Barajas‐Gamboa¹,

Huidobro

Jensen

et al. 2020

Robotics Computer Surgery

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Background Magnetic technologies have been introduced to reduce invasiveness of surgical procedures. This study was aimed to analyse the performance of a novel combined magnetic‐robotic controller as an enhanced accessory to the Magnetic Surgical System in laparoscopic cholecystectomy (LC). Methods This was a prospective study of 10 consecutive patients undergoing LC with this novel surgical system. Results Ten patients were included, nine were female. The mean age was 30.3 ± 9 years. All patients had chronic cholecystitis. Procedures were completed successfully. The median operative time was 50 ± 11 min. The system performed effectively in all cases with no need of additional interventions. There were no device‐related complications or side effects. All patients were discharged the same day. Recovery was uneventful during follow‐up. Conclusions This study demonstrates the first in‐human successful performance of surgeries utilizing a novel combination of magnetic and robotic technologies in one integrated system.

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Use of magnets in gastrointestinal surgery

Cited by 28 publications

References 58 publications

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

Effects of Warmed and Humidified CO₂ Surgical Site Insufflation in a Novel Experimental Model of Magnetic Compression Colonic Anastomosis

First in‐human experience with a novel robotic platform and Magnetic Surgery System

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Use of magnets in gastrointestinal surgery

Cited by 28 publications

References 58 publications

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

Magnetic compression anastomosis with atypical anastomosis for anastomotic stenosis of the sigmoid colon: a case report

Effects of Warmed and Humidified CO2 Surgical Site Insufflation in a Novel Experimental Model of Magnetic Compression Colonic Anastomosis

First in‐human experience with a novel robotic platform and Magnetic Surgery System

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Effects of Warmed and Humidified CO₂ Surgical Site Insufflation in a Novel Experimental Model of Magnetic Compression Colonic Anastomosis