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Magnetic liver retraction

Magnetic liver retraction incision-less technique is a safe

Technique enables port-less liver mobilisation and facilitates surgical exposure while decreasing incisions

Levita Magnetic Surgical System facilitates a safe, reproducible, incision-less technique for port-less intra-abdominal liver retraction during bariatric surgery, according to researchers from Duke University Health System in Durham, NC. The study noted that the device successfully permitted optimal liver retraction during laparoscopic bariatric surgery, facilitating surgical exposure while decreasing the number of abdominal incisions. The outcomes are featured in the paper, “Magnetic Liver Retraction: an Incision-Less Approach for Less Invasive Bariatric Surgery,” published in Obesity Surgery, the official journal of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).

Retraction of the liver is essential to ensure appropriate visualisation of the surgical field during bariatric surgery. In conventional laparoscopic bariatric procedures, shafted surgical instruments are introduced by fixed-position trocars inserted through incisions in the abdomen. Magnetic surgery facilitates access and visualization of the surgical site and enables procedures with a reduced number of incisions and trocars.

The Levita Magnetic Surgical System enables reduced-port laparoscopic surgical procedures designed to minimize the footprint of surgery. The system, which consists of an external magnet placed on the skin that controls a shaftless detachable grasper, enables instruments to move without the constraints of a fixed-position pivot point, and facilitates access and visualization of the surgical site. In the US, the Levita Magnetic Surgical System is indicated to grasp and retract the body and the fundus of the gallbladder in laparoscopic cholecystectomy procedures and the liver in bariatric procedures to facilitate access and visualisation of the surgical site in patients with a BMI20-60.

The study authors retrospectively reviewed 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 in total were comprised of 29 primary sleeve gastrectomies, 24 gastric bypasses, ten duodenal switches, three gastric band removals and seven revisions.

“Magnetic bariatric surgery offers a safe and less invasive alternative to bariatric patients who are seeking better cosmetic outcomes after surgery,” said Dr A Daniel Guerron, weight loss surgeon at Duke University Health System. “We are pleased to be the first in the US to pioneer and study this innovative approach to weight loss surgery.”

Mean pre-operative BMI was 43.6 kg/m2 (range 18.3-67.7 kg/m2) and the 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 utilisation as technically simple even for the large livers.

 “Levita’s goal is to enhance patient outcomes by minimizing the footprint of surgical procedures across multiple indications and broad patient populations,” said surgeon Alberto Rodriguez-Navarro, CEO and founder, Levita Magnetics. “This data is additional important evidence for the utility and safety of Magnetic Surgery – a technique we believe can become standard of care in the future for a variety of procedures.”

To date, patients have undergone Magnetic Surgery at leading clinical centres including the Cleveland Clinic, UT Southwestern Medical Center, Stanford University and Duke University, among others.

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