10-mm Laparo-Endoscopic Single-Site Cholecystectomy Using Multiple Magnetically Anchored and Controlled Instruments

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Gastrointestinal Surgery

Background:

• Advancements in surgical techniques aim to reduce invasiveness.
• Laparo-endoscopic single-site (LESS) surgery offers potential benefits over traditional laparoscopy.
• Novel instrumentation is crucial for expanding the application of LESS procedures.

Purpose of the Study:

• To evaluate the feasibility of performing laparo-endoscopic single-site (LESS) cholecystectomy.
• To assess a novel miniature magnetically anchored and controlled laparoscopy and grasper system.
• To determine the safety and efficacy of this system in a canine model.

Main Methods:

• A miniature magnetically anchored camera (MMAC) and a magnetically anchored grasper (MAG) system were utilized.
• These systems were externally controlled via magnetic anchoring units.
• The combined system was employed for LESS cholecystectomy through a single 10-mm incision in six canine models.

Main Results:

• The procedure was successfully completed in four out of six cases.
• Mean operative time was 85.75 minutes.
• The MMAC provided clear visualization, and the MAG offered adequate tissue manipulation, with no significant instrument collisions observed.

Conclusions:

• The developed magnetic anchoring and control system demonstrated maneuverability.
• LESS cholecystectomy appears feasible using a single 10-mm incision with simultaneous use of multiple magnetic instruments.
• Further research is warranted to refine the technique and assess its broader clinical applicability.