Department of Surgery, Division of Weight Loss and Metabolic Surgery, Duke University Medical Center, 407 Crutchfield Street, Durham, NC, 27704, USA.
Obes Surg. 2019 Mar;29(3):1068-1073. doi: 10.1007/s11695-018-03655-w.
In bariatric surgery, retraction of the liver is essential to ensure appropriate visualization of the surgical field. Many devices are currently employed for this purpose. Generally, these devices require constant use of a port, or an additional incision. Magnetic technology provides a novel solution, by allowing liver retraction during bariatric procedures that do not require a dedicated port nor an extra incision.
Retrospective review of consecutive patients who underwent magnetic-assisted liver retraction during primary or revisional laparoscopic bariatric surgery at the Duke Center for Metabolic and Weight Loss Surgery between October 2016 and August 2017.
The 73 cases were comprised of 29 primary sleeve gastrectomies, 24 gastric bypasses, 10 duodenal switches, 3 gastric band removals, and 7 revisions. All cases were completed laparoscopically. Mean pre-operative BMI was 43.6 kg/m (range 18.3-67.7 kg/m). Mean operative times for primary cases were similar to published averages. Two patients experienced minor 30-day morbidities, neither of which were attributed to the device and did not require further interventions. There were no 30-day mortalities. Surgeons described subjective overall surgical exposure as adequate and device utilization as technically simple even for the large livers.
Magnetic-assisted retraction is a novel approach that allows a safe, reproducible, incision-less technique for unconstrained, port-less intra-abdominal mobilization. The device successfully permitted optimal liver retraction during laparoscopic bariatric surgery, enhancing surgical exposure while decreasing the number of abdominal incisions.
在减重手术中，肝脏的牵拉对于确保手术视野的适当显露至关重要。目前有许多设备用于实现这一目标。通常，这些设备需要持续使用一个端口或额外的切口。磁性技术提供了一种新颖的解决方案，允许在不需要专用端口或额外切口的减重手术中进行肝脏牵拉。
回顾性分析 2016 年 10 月至 2017 年 8 月期间在杜克代谢与减重手术中心接受磁辅助肝脏牵拉的连续患者的病例。
73 例患者中包括 29 例原发性袖状胃切除术、24 例胃旁路术、10 例十二指肠转位术、3 例胃束带去除术和 7 例修正术。所有病例均通过腹腔镜完成。术前 BMI 平均为 43.6kg/m²（范围为 18.3-67.7kg/m²）。原发性手术的平均手术时间与已发表的平均值相似。有 2 例患者在 30 天内发生轻微的并发症，但都与该设备无关，也不需要进一步干预。无 30 天死亡病例。外科医生描述主观整体手术显露充分，即使对于大的肝脏，设备的使用也很简单。
磁辅助牵拉是一种新颖的方法，允许安全、可重复、无切口的技术实现无约束、无端口的腹腔内活动。该设备成功地允许在腹腔镜减重手术中进行最佳的肝脏牵拉，增强了手术显露，同时减少了腹部切口的数量。
