title: An application research on a novel internal grasper platform and magnetic anchoring guide system (MAGS) in laparoscopic surgery.
abstract: Laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery attempt to reduce transabdominal port sites. These require all instruments to pass through a single access point, leading to instruments collide or work at unfamiliar angles. Thus, we designed an internal grasper under magnetic anchoring guide system (MAGS) platform and investigated its utility and operability.
  
  
  
  We measured the configuration for magnetic force decay over distance using a standardized, ex vivo laboratory testing apparatus. An electronic balance was used to measure the force of the gallbladder pull in ten patients with gallbladder stones. One pig (11 mm abdominal wall thickness) underwent a compressed trial of MAGS platform. The device was left in place for 20 min before tissue sections were harvested, and histologic assessment was performed. The utility and operability were investigated in four pigs (38-280 kg weight).
  
  
  
  The magnetic attraction force decayed exponentially over distance; the force of pulling gallbladder was 7.46 ± 0.54 N. This pairing of components allowed for coupling to a theoretical distance of 10 mm. No gross tissue damage was observed. H-E stain showed no necrosis in all specimens. One failed due to wall thickness of 45 mm. Others showed the critical view, triangulation of instruments was obtained, and instrument collision or "sword fighting" was reduced.
  
  
  
  The MAGS platform overcomes limitations such as collisions and lack of triangulation, reduces transabdominal port sites, and is easy to operate. However, our internal grasper requires the abdominal wall thickness below 10 mm.
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.|Department of General Surgery, Xi'an Central Hospital, Xi'an, Shaanxi, China.
authors.forename: Yafei
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Department of General Surgery, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, Shaanxi, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.|Department of General Surgery, Xi'an Central Hospital, Xi'an, Shaanxi, China.
authors.forename: Da
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Shi
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Dinghui
authors.initials: D
authors.lastname: Dong
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Shanpei
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Ma
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Haohua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.|Department of Surgical Oncology, Shaanxi Province People's Hospital, Xi'an, Shaanxi, China.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Xuemin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Northwest Nonferrous Metal Research Institute, Xi'an, Shaanxi, China.
authors.forename: Ruixue
authors.initials: R
authors.lastname: Luo
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
authors.forename: Rongqian
authors.initials: R
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, Shaanxi Center for Regenerative Medicine and Surgical Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China. luyi169@126.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000818:Animals; D004867:Equipment Design; D010535:Laparoscopy; D008280:Magnetics / Q000295:instrumentation*; D023421:Models, Animal; D013525:Surgical Instruments; D013552:Swine
keywords: Instruments; Internal grasper; Magnetic anchoring and guidance system (MAGS)