title: The use of magnets with single-site umbilical laparoscopic surgery.
abstract: Single-site umbilical incision laparoscopic surgery (SSULS) is increasingly being used to treat a variety of childhood surgical diseases. Existing SSULS approaches have inefficient triangulation and poor ergonomics. In an effort to overcome these shortcomings, magnet-assisted laparoscopy was developed. Specialized magnetic graspers are introduced through a standard 12-mm port and are controlled by a powerful external magnet. This study is a retrospective analysis of all magnet-assisted laparoscopic operations performed at the Fundacion Hospitalaria Private Children's Hospital from September 2009 to January 2011. Outcomes include demographics, diagnosis, operative time, intraoperative complications, and conversion rates. Forty-four magnet-assisted laparoscopic operations were performed. The operations included 23 appendectomies, 8 cholecystectomies, 3 Nissen fundoplications, 2 gastrojejunostomies, 2 splenectomies, 2 ovarian tumor/cyst resections, 1 retroperitoneal lymphangioma resection, 1 left adrenalectomy, 1 total abdominal colectomy and 1 pulmonary wedge resection. The mean operative times for the most commonly performed operations were 61 minutes for appendectomy and 93 minutes for cholecystectomy. The operations were classified as follows: Group I, adjunct to conventional laparoscopy (5 operations); Group II, adjunct to multiple-access umbilical laparoscopy (11 operations); and Group III, true single-port laparoscopy (28 operations). Among Group II/III operations, 6 operations required 1 additional port outside the umbilicus. No operations required more that 1 additional port, and no operations were converted to the open technique. There were no intraoperative complications. Magnet-assisted laparoscopic surgery is safe and effective in children. The use of magnetic graspers improves triangulation and ergonomics while reducing the number and size of abdominal incisions.
authors.affiliation: Department of Surgery, Fundacion Hospitalaria Children's Hospital, Buenos Aires, Argentina.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Padilla
authors.forename: Guillermo
authors.initials: G
authors.lastname: Dominguez
authors.forename: Carolina
authors.initials: C
authors.lastname: Millan
authors.forename: Marcelo
authors.initials: M
authors.lastname: Martinez-Ferro
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000145:classification / Q000295:instrumentation* / Q000379:methods*; D008280:Magnetics / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D014472:Umbilicus / Q000601:surgery*; D055815:Young Adult