title: Magnetically anchored cautery dissector improves triangulation, depth perception, and workload during single-site laparoscopic cholecystectomy.
abstract: BACKGROUND
  This study evaluated operative outcomes and workload during single-site laparoscopy (SSL) using a magnetically anchored cautery dissector (MAGS) compared with a conventional laparoscopic hook cautery (LAP).
  
  
  METHODS
  Each cautery was used to perform six SSL porcine cholecystectomies. For MAGS, the cautery device was inserted through the umbilical incision, magnetically coupled, and deployed; two graspers and a laparoscope were used. For LAP, two percutaneous retraction sutures, one grasper, a hook cautery dissector, and a laparoscope were used. Operative outcomes, surgeon ratings (scale, 1-5; 1 = superior), and workload (scale, 1-10; 1 = superior) were evaluated.
  
  
  RESULTS
  No significant differences were detected for operative outcomes and surgeon ratings, however, trends were detected favoring MAGS. Surgeon workload ratings were significantly better for MAGS (2.6 ± 0.2) vs. LAP (5.6 ± 1.1; p < 0.05). For MAGS, depth perception and triangulation were excellent and the safe handling protocol was followed with no complications. For LAP, the parallelism of instruments and lack of triangulation hindered depth perception, caused instrument conflicts, and resulted in two minor complications (one superficial liver laceration and one inadvertent burn to the diaphragm).
  
  
  CONCLUSIONS
  These data suggest that using the MAGS device for SSL cholecystectomy results in equivalent (or better) operative outcomes and less workload compared with LAP.
authors: Department of Surgery, Southwestern Center for Minimally Invasive Surgery, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9156, USA.
authors: Nabeel A
authors: NA
authors: Arain
authors: Jeffrey A
authors: JA
authors: Cadeddu
authors: Deborah C
authors: DC
authors: Hogg
authors: Richard
authors: R
authors: Bergs
authors: Raul
authors: R
authors: Fernandez
authors: Daniel J
authors: DJ
authors: Scott
mesh_terms: D000818:Animals; D002425:Cautery / Q000295:instrumentation*; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D003867:Depth Perception; D004210:Dissection / Q000295:instrumentation*; D008280:Magnetics; D023421:Models, Animal; D013552:Swine; D016526:Workload