1
|
Liang NE, Lin S, Slater BJ, Bruzoni M. Use of magnets in pediatric surgery. Semin Pediatr Surg 2024; 33:151381. [PMID: 38194748 DOI: 10.1016/j.sempedsurg.2024.151381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Since the 1970s, magnets have been progressively harnessed for use in minimally invasive treatment of pediatric surgical disease. In particular, multiple magnetic devices have been developed for treating esophageal atresia, pectus excavatum and scoliosis. These devices, which can be placed via small incisions or under endoscopic or fluoroscopic guidance, provide the added benefit of sparing patients multiple large, invasive procedures, and allowing for gradual correction of congenital anomalies over days to months, depending on the disease. In the following text, we detail the current landscape of magnetic devices used by pediatric surgeons, illustrate their use through clinical cases, and review the available body of literature with respect their outcomes and complications.
Collapse
Affiliation(s)
- Norah E Liang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB-425, Boston, MA 02138, USA.
| | - Saunders Lin
- Department of Surgery, Division of Pediatric Surgery, University of Chicago School of Medicine, Chicago, IL, USA
| | - Bethany J Slater
- Department of Surgery, Division of Pediatric Surgery, University of Chicago School of Medicine, Chicago, IL, USA
| | - Matias Bruzoni
- Texas Children's Hospital Austin, Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine, Austin, TX, USA
| |
Collapse
|
2
|
Lee WG, Evans LL, Harrison MR. Beyond the gut: spectrum of magnetic surgery devices. Front Surg 2023; 10:1253728. [PMID: 37942002 PMCID: PMC10628496 DOI: 10.3389/fsurg.2023.1253728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
Since the 1970s, magnetic force has been used to augment modern surgical techniques with the aims of minimizing surgical trauma and optimizing minimally-invasive systems. The majority of current clinical applications for magnetic surgery are largely centered around gastrointestinal uses-such as gastrointestinal or bilioenteric anastomosis creation, stricturoplasty, sphincter augmentation, and the guidance of nasoenteric feeding tubes. However, as the field of magnetic surgery continues to advance, the development and clinical implementation of magnetic devices has expanded to treat a variety of non-gastrointestinal disorders including musculoskeletal (pectus excavatum, scoliosis), respiratory (obstructive sleep apnea), cardiovascular (coronary artery stenosis, end-stage renal disease), and genitourinary (stricture, nephrolithiasis) conditions. The purpose of this review is to discuss the current state of innovative magnetic surgical devices under clinical investigation or commercially available for the treatment of non-gastrointestinal disorders.
Collapse
Affiliation(s)
- William G. Lee
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Lauren L. Evans
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Michael R. Harrison
- Department of Surgery, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
3
|
Lee WG, Evans LL, Johnson SM, Woo RK. The Evolving Use of Magnets in Surgery: Biomedical Considerations and a Review of Their Current Applications. Bioengineering (Basel) 2023; 10:bioengineering10040442. [PMID: 37106629 PMCID: PMC10136001 DOI: 10.3390/bioengineering10040442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
The novel use of magnetic force to optimize modern surgical techniques originated in the 1970s. Since then, magnets have been utilized as an adjunct or alternative to a wide array of existing surgical procedures, ranging from gastrointestinal to vascular surgery. As the use of magnets in surgery continues to grow, the body of knowledge on magnetic surgical devices from preclinical development to clinical implementation has expanded significantly; however, the current magnetic surgical devices can be organized based on their core function: serving as a guidance system, creating a new connection, recreating a physiologic function, or utilization of an internal–external paired magnet system. The purpose of this article is to discuss the biomedical considerations during magnetic device development and review the current surgical applications of magnetic devices.
Collapse
Affiliation(s)
- William G. Lee
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Lauren L. Evans
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sidney M. Johnson
- Department of Surgery, University of Hawaii, Honolulu, HI 96822, USA
| | - Russell K. Woo
- Department of Surgery, University of Hawaii, Honolulu, HI 96822, USA
| |
Collapse
|
4
|
Li Y, Zhang M, Shi A, Liu P, Zhang H, Zhang Y, Lyu Y, Yan X. Magnetic anchor technique-assisted thoracoscopic lobectomy in beagles. Sci Rep 2022; 12:11916. [PMID: 35831463 PMCID: PMC9279439 DOI: 10.1038/s41598-022-16050-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/04/2022] [Indexed: 01/22/2023] Open
Abstract
In single-port thoracoscopic lobectomy, surgical instruments are likely to collide and interfere with each other. We used magnetic anchor technique to design an anchoring device suitable for thoracoscopic surgery, and verified the safety and feasibility of its use in animal experiments. Ten Beagles were used as models, and magnetic anchor technology was used to assist thoracoscopic lobectomy. During the operation, a self-designed magnetic anchored internal grasper was used in place of the traditional laparoscopic grasping forceps. The operation time, intraoperative blood loss, incidence of postoperative complications, and the effect of intraoperative use of the device were analyzed. All 10 beagles were successfully operated; the mean operation time was 19.7 ± 3.53 min (range 15-26 min), and the postoperative blood loss was < 10 mL. No surgical complications occurred. During the operation, the internal grasper was firmly clamped, the auxiliary operation field was well exposed, and the interference of the main operation hole instruments was effectively reduced. We provide preliminary experimental evidence of the safety and feasibility of magnetic anchor technique-assisted thoracoscopic lobectomy.
Collapse
Affiliation(s)
- Yixing Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.,Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Miaomiao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.,National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Aihua Shi
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Peinan Liu
- Qide College, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Hanzhi Zhang
- Qide College, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Yong Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Yi Lyu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China. .,National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
| | - Xiaopeng Yan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China. .,National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
| |
Collapse
|
5
|
David VL. Current Concepts in the Etiology and Pathogenesis of Pectus Excavatum in Humans-A Systematic Review. J Clin Med 2022; 11:jcm11051241. [PMID: 35268332 PMCID: PMC8911421 DOI: 10.3390/jcm11051241] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/16/2023] Open
Abstract
Pectus excavatum (PE) is the most common deformity of the chest wall and is characterized by the posterior depression of the sternum and the lower costal cartilages. To date, the etiology of PE in humans remains enigmatic. Several etiologic hypotheses have been proposed over the past two centuries. However, most of them have been scientifically dismissed and now have only historic value. In this systematic review, we assess scientific publications of the past two centuries addressing the issue of the origin of PE in humans. We present and discuss the histologic, genetic, biomechanical, and experimental scientific achievements that contributed to the clarification of its etiology and pathogenesis. With no clear consensus over the exact mechanism, most recent studies agree that the primordial defect leading the deformation of the anterior chest wall in PE is related to the costal hyaline cartilage structure and function. Further studies on this subject must be carried out. Genetic studies seem to be the most promising way to understand the exact mechanism of PE's origin and pathogenesis.
Collapse
Affiliation(s)
- Vlad Laurentiu David
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu, 300041 Timisoara, Romania
| |
Collapse
|
6
|
Bai JG, Wang Y, Zhang Y, Lv Y. Expert consensus on the application of the magnetic anchoring and traction technique in thoracoscopic and laparoscopic surgery. Hepatobiliary Pancreat Dis Int 2022; 21:7-9. [PMID: 34289952 DOI: 10.1016/j.hbpd.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/28/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Ji-Gang Bai
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yue Wang
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yong Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
| | - Yi Lv
- Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
| |
Collapse
|
7
|
Endoscopic Magnetic Compression Anastomosis For Small Bowel Bypass in a High Operative Risk Setting. Surg Laparosc Endosc Percutan Tech 2020; 29:e84-e87. [PMID: 31107851 DOI: 10.1097/sle.0000000000000669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The endoscopic enteroenteral bypass could revolutionize the treatment of small bowel obstruction (SBO) in inoperable patients. We describe the technique of endoscopic delivery of a magnetic compression anastomosis device and the creation of an enteroenteral anastomosis in a patient with recurrent acute on chronic SBOs and prohibitively high operative risk. In this novel procedure, a magnetic compression anastomosis device is delivered on either side of the obstruction using a hybrid endoscopic/fluorographic technique, effectively bypassing the obstruction and relieving symptoms. The anastomosis was endoscopically evaluated at regular intervals postprocedure. By 7 days, healthy villi were visible through the mated magnetic rings. By 10 days, the anastomosis was widely patent. The rings passed through the ileostomy and were evacuated, and the patient's symptoms completely resolved. The anastomosis remained widely patent at 1 year. In summary, this case demonstrates the benefit of magnetic compression anastomosis in a patient with SBO and high operative risk.
Collapse
|
8
|
Graves CE, Co C, Hsi RS, Kwiat D, Imamura-Ching J, Harrison MR, Stoller ML. Magnetic Compression Anastomosis (Magnamosis): First-In-Human Trial. J Am Coll Surg 2017; 225:676-681.e1. [DOI: 10.1016/j.jamcollsurg.2017.07.1062] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/09/2017] [Accepted: 07/10/2017] [Indexed: 01/28/2023]
|