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首次使用磁性肝脏牵开器进行减少切口减重手术的前瞻性临床试验。

First prospective clinical trial of reduced incision bariatric procedures using magnetic liver retraction.

作者信息

Luengas Rafael, Galindo Jose, Castro Melissa, Marambio Andres, Watkins Guillermo, Rodriguez Del Rey Mario, Davanzo Cristobal, Portenier Dana, Guerron Alfredo D

机构信息

Hospital La Florida, Department of Surgery, Santiago de Chile, Chile; Redsalud Santiago, Santiago, Chile.

Duke University Health System, Department of Surgery, Division of Metabolic and Weight Loss Surgery, Durham, North Carolina.

出版信息

Surg Obes Relat Dis. 2021 Jan;17(1):147-152. doi: 10.1016/j.soard.2020.08.017. Epub 2020 Aug 26.

Abstract

BACKGROUND

Exposure of the surgical field is an essential component of minimally invasive surgery. Liver retraction is an important element of bariatric procedures because visualization of the stomach and gastroesophageal junction is key. The magnetic surgical system provides a well-tolerated and effective option for adjustable liver retraction without the use of a dedicated port.

OBJECTIVE

The purpose of this study was to evaluate the safety profile and effectiveness of the magnetic surgical system in patients undergoing bariatric procedures.

SETTING

Two investigational sites in Chile.

METHODS

A prospective, single-arm study (ClinicalTrials.govNCT03508674) with adherence to Good Clinical Practices and ISO 14155:2011(E) was undertaken to evaluate the safety profile and effectiveness of the magnetic surgical system in patients undergoing bariatric surgery. Patient follow-up occurred at 7 and 30 days postprocedure.

RESULTS

A total of 50 patients who met the inclusion criteria had a body mass index ranging from 28.4 to 58.2 kg/m. All procedures were completed without complications or conversions. The average overall procedure time was 61 minutes, and the amount of coupling time between the magnetic controller and the detachable grasper was 37 minutes. In all cases the device was able to adequately retract the liver to achieve an effective exposure of the target tissue and perform the bariatric procedure. A total of 24 adverse effects were reported throughout the course of the study. All device-related adverse effects were mild in severity and resolved with no clinical sequelae.

CONCLUSION

The magnetic surgical system is a well-tolerated and effective option for liver retraction in minimally invasive and bariatric surgery in patients with a varying range of body mass indexes.

摘要

背景

手术视野的暴露是微创手术的重要组成部分。肝脏牵拉是减重手术的重要环节,因为胃和胃食管交界处的可视化是关键。磁外科系统为可调节肝脏牵拉提供了一种耐受性良好且有效的选择,无需使用专用端口。

目的

本研究旨在评估磁外科系统在接受减重手术患者中的安全性和有效性。

地点

智利的两个研究地点。

方法

开展一项前瞻性单臂研究(ClinicalTrials.govNCT03508674),遵循良好临床实践和ISO 14155:2011(E)标准,以评估磁外科系统在接受减重手术患者中的安全性和有效性。术后7天和30天对患者进行随访。

结果

共有50名符合纳入标准的患者,体重指数范围为28.4至58.2kg/m。所有手术均顺利完成,无并发症或中转。平均总手术时间为61分钟,磁控制器与可拆卸抓取器之间的耦合时间为37分钟。在所有病例中,该设备均能够充分牵拉肝脏,有效暴露目标组织并完成减重手术。在整个研究过程中,共报告了24例不良反应。所有与设备相关的不良反应均为轻度,且未留下临床后遗症而自行缓解。

结论

对于不同体重指数范围的患者,磁外科系统是微创减重手术中肝脏牵拉的一种耐受性良好且有效的选择。

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