Single Trocar Laparoscopic Nephrectomy Using Magnetic Anchoring and Guidance System in the Porcine Model

Ilia S. Zeltser, Richard Bergs, Raul Fernandez, Linda A Baker, Robert Eberhart, Jeffrey A Cadeddu

Research output: Contribution to journalArticle

103 Scopus citations

Abstract

Purpose: We assessed the feasibility of single keyhole laparoscopic surgery using a novel transabdominal magnetic anchoring and guidance system platform in the porcine model. Materials and Methods: A collaborative research group was formed to build a prototype system of magnetically anchored instruments for trocar-free laparoscopy. The design mandate was that the developed technology should be able to deploy into the insufflated abdomen through an existing 12 mm diameter trocar and then be moved into position in the peritoneum by manipulating external magnets. The magnetic anchoring and guidance system concept was advanced to a working prototype with a system of external magnetic anchors, an internal camera system and a hook cautery supported by an intra-abdominal robotic arm. This prototype system was then evaluated in vivo in a porcine laparoscopic nephrectomy model. Results: Two nonsurvival porcine laparoscopic nephrectomies were successfully completed without complications via a single 15 mm transumbilical trocar using the prototype magnetic anchoring and guidance system camera and the magnetically anchored robotic arm cauterizer. A conventional laparoscopic grasper was used for retraction through the 15 mm trocar after magnetic anchoring and guidance system deployment. The renal artery and vein were transected with a conventional Endo-GIA® stapler introduced through the 15 mm trocar. Procedure time was not recorded and blood loss was minimal. Conclusions: Single trocar laparoscopic nephrectomy using magnetically anchored instrumentation is technically feasible, demonstrating that intracorporeal instrument manipulation may overcome the limitations of current laparoscopic and robotic surgery by allowing unhindered intra-abdominal movement. This single access technique may be used with natural orifice surgery approaches and it has the potential to realize incision-free intra-abdominal surgery.

Original languageEnglish (US)
Pages (from-to)288-291
Number of pages4
JournalJournal of Urology
Volume178
Issue number1
DOIs
StatePublished - Jul 1 2007

Keywords

  • instrumentation
  • kidney
  • laparoscopy
  • nephrectomy
  • swine

ASJC Scopus subject areas

  • Urology

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