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J Gastrointest Surg (2012) 16:18071813 DOI 10.1007/s11605-012-1926-2
MULTIMEDIA ARTICLE
Magnetically Anchored Cautery Dissector Improves Triangulation, Depth Perception, and Workload During Single-Site Laparoscopic Cholecystectomy
Nabeel A. Arain & Jeffrey A. Cadeddu &
Deborah C. Hogg & Richard Bergs & Raul Fernandez &
Daniel J. Scott
Received: 4 January 2012 /Accepted: 30 May 2012 /Published online: 29 June 2012 # 2012 The Society for Surgery of the Alimentary Tract
AbstractIntroduction This study evaluated operative outcomes and workload during single-site laparoscopy (SSL) using a magnetically anchored cautery dissector (MAGS) compared with a conventional laparoscopic hook cautery (LAP).
Methods Each cautery was used to perform six SSL porcine cholecystectomies. For MAGS, the cautery device was inserted through the umbilical incision, magnetically coupled, and deployed; two graspers and a laparoscope were used. For LAP, two percutaneous retraction sutures, one grasper, a hook cautery dissector, and a laparoscope were used. Operative outcomes, surgeon ratings (scale, 15; 10superior), and workload (scale, 110; 10superior) were evaluated.
Results No significant differences were detected for operative outcomes and surgeon ratings, however, trends were detected favoring MAGS. Surgeon workload ratings were significantly better for MAGS (2.60.2) vs. LAP (5.61.1; p<0.05). For MAGS, depth perception and triangulation were excellent and the safe handling protocol was followed with no complications. For LAP, the parallelism of instruments and lack of triangulation hindered depth perception, caused instrument conflicts, and resulted in two minor complications (one superficial liver laceration and one inadvertent burn to the diaphragm).
Conclusion These data suggest that using the MAGS device for SSL cholecystectomy results in equivalent (or better) operative outcomes and less workload compared with LAP.
Keywords Magnetic anchoring and guidance system (MAGS) . Magnetic instruments . Single-site laparoscopy (SSL) . Triangulation . Workload
Introduction
Over the past several years, techniques for reducing the number of access ports within minimally invasive surgery (MIS) have evolved considerably. Fueled largely by a patient-driven demand,1 interest is increasing in minimizing the invasiveness of abdominal surgery. Single-site laparos-copy (SSL) is currently an area in MIS of active growth and interest as investigators search for methods to further minimize the invasiveness of surgical procedures.24
SSL may potentially provide a variety of patient benefits.
According to recent studies, data are emerging that support these claims in regards to enhanced cosmesis, decreased...