V1025 NEW GENERATION MAGNETIC CAMERA FACILITATES PORCINE LESS NEPHRECTOMY (2011)

You have accessJournal of UrologyKidney & Ureter Oncology1 Apr 2011V1025 NEW GENERATION MAGNETIC CAMERA FACILITATES PORCINE LESS NEPHRECTOMY Sara Best, Ephrem Olweny, Samuel Park, Paul Smith, Raul Fernandez, Daniel Scott, Richard Bergs, and Jeffrey Cadeddu Sara BestSara Best Dallas, TX More articles by this author , Ephrem OlwenyEphrem Olweny Dallas, TX More articles by this author , Samuel ParkSamuel Park Dallas, TX More articles by this author , Paul SmithPaul Smith Dallas, TX More articles by this author , Raul FernandezRaul Fernandez Arlington, TX More articles by this author , Daniel ScottDaniel Scott Dallas, TX More articles by this author , Richard BergsRichard Bergs Arlington, TX More articles by this author , and Jeffrey CadedduJeffrey Cadeddu Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1060AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparo-endoscopic single site (LESS) surgery is significantly limited by instrument clashing and loss of triangulation. We have been working on magnetically anchored and guided (MAGS) instruments to facilitate LESS and NOTES procedures. These devices consist of a handheld external magnet that couples across the abdominal wall to the intracorporeal magnetic tool. The handheld component is then used to steer the tool into place inside the peritoneal cavity. We herein report and demonstrate a new MAGS camera with improved optics which facilitates porcine LESS nephrectomy. METHODS The prototype is a 1.4 cm cylinder measuring 7.8 cm long containing magnets positioned such that the camera sits on the parietal peritoneal surface once it couples with the handheld external magnet. It was inserted through a 3 cm umbilical incision on a 34kg pig. A commercially-available LESS port was inserted alongside the camera cable. After insufflation, the camera was coupled with the handheld magnetic device across the anterior abdominal wall (1.5 cm thick) and was steered into position to view the kidney. A nephrectomy was then performed using rigid, straight instruments only. At no time was a standard laparoscope used to facilitate dissection. RESULTS The nephrectomy was completed successfully in 35 minutes with scant blood loss and no intra- or post-operative complications during the 2 week convalescent period. The image generated by the MAGS camera was excellent and virtually indistinguishable from that of a standard laparoscope. The lens required cleaning once and this was performed without removing the camera from the abdominal cavity. Positioning of the camera for optimal visualization of the procedure was easily performed and was enhanced by its independence from the port site. The diminished competition for working space in the port site allowed for the use of straight rather than articulating instruments and substantially improved the ease of the operation by restoring some triangulation. CONCLUSIONS The new MAGS camera design provides excellent optics, improves triangulation and improves maneuverability during LESS nephrectomy. Like other MAGS instruments, by replacing a traditional transabdominal laparoscope that requires portsite space, use of this insertable camera may diminish some of the “collision challenge” of LESS surgery. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e413 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Sara Best Dallas, TX More articles by this author Ephrem Olweny Dallas, TX More articles by this author Samuel Park Dallas, TX More articles by this author Paul Smith Dallas, TX More articles by this author Raul Fernandez Arlington, TX More articles by this author Daniel Scott Dallas, TX More articles by this author Richard Bergs Arlington, TX More articles by this author Jeffrey Cadeddu Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...