Experimental study of magnetic anchoring and traction device assisting thoracoscopic esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Wenwen ^1,2 , YAN Xiaopeng ^3,4 , LEI Fengping ^1,2 , YANG Cheng ^1,2 , LV Yi ^3,4 , FU Junke ¹ ,  ZHANG Yong ^1,4

1. Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
2. Qide College, Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;
4. National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, P.R.China;

Corresponding?author：

ZHANG Yong, Email: zhangyongyang05@163.com

Keywords：

Magnetic anchoring and traction technique; thoracoscopy; esophageal traction; Beagle dogs; animal experiment

DOI：

10.7507/1007-4848.202008027

Video：

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Objective To verify the feasibility of a self-designed magnetic anchoring and traction device (MATD) for assisting two-port video-assisted thoracoscopic esophagectomy.Methods Three Beagle dogs were selected as animal models with age ranging from 1-6 years and weight ranging from 8-12 kg, and they underwent two-port video-assisted thoracoscopic esophagectomy after general anesthesia. We used the MATD to retract the esophagus to different directions, which assisted mobilizing esophagus, detecting the nerves along esophagus and dissecting paraesophagus lymph nodes. The operation time, blood loss and feasibility of the MATD were recorded.Results With the aid of the MATD, we successfully retracted and mobilized the esophagus, detected the nerves and dissected the lymph nodes in three Beagle dog models. During the operation, the MATD provided sufficient and steady traction of esophagus to achieve a good exposure of the operative field, effectively decreasing the interference between working instruments. The MATD worked well. The mean operation time was 30 min, and the mean intraoperative blood loss was about 10 mL.Conclusion It is effective to use the MATD to assist retracting esophagus during video-assisted thoracoscopic esophagectomy. The magnetic anchoring and traction technique can assist to expose the surgical field, decrease the interference between the working instruments and have the potential clinical application.

Citation： CHEN Wenwen, YAN Xiaopeng, LEI Fengping, YANG Cheng, LV Yi, FU Junke, ZHANG Yong. Experimental study of magnetic anchoring and traction device assisting thoracoscopic esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1090-1094. doi: 10.7507/1007-4848.202008027 Copy

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2.	龔太乾. 微創食管切除術術式演變與個體化選擇. 轉化醫學雜志, 2019, 8(5): 262-265.
3.	Zheng W, Zhu Y, Guo CH, et al. Esophageal suspension method in scavenging peripheral lymph nodes of the left recurrent laryngeal nerve in thoracic esophageal carcinoma through semi-prone-position thoracoscopy. J Cancer Res Ther, 2014, 10(4): 985-990.
4.	Oshikiri T, Yasuda T, Harada H, et al. A new method (the "Bascule method") for lymphadenectomy along the left recurrent laryngeal nerve during prone esophagectomy for esophageal cancer. Surg Endosc, 2015, 29(8): 2442-2450.
5.	Oshikiri T, Nakamura T, Hasegawa H, et al. Reliable surgical techniques for lymphadenectomy along the left recurrent laryngeal nerve during thoracoscopic esophagectomy in the prone position. Ann Surg Oncol, 2017, 24(4): 1018.
6.	林淼, 沈亞星, 汪灝, 等. 微創食管手術中食管懸吊法清掃左喉返神經旁淋巴結的臨床療效分析. 中國臨床醫學, 2016, 23(4): 484-487.
7.	沈國義, 張奕, 戴益智, 等. 胸腔內食管牽引挑離法在微創食管癌切除術中左側喉返神經旁淋巴結清掃的應用. 中國微創外科雜志, 2018, 18(5): 401-404, 408.
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9.	劉清松, 胡偉鵬, 陳龍奇, 等. 單孔胸腔鏡食管癌切除術的現狀與進展. 中華消化外科雜志, 2018, 17(8): 800-803.
10.	Cuesta MA. Review of different approaches of the left recurrent laryngeal nerve area for lymphadenectomy during minimally invasive esophagectomy. J Thorac Dis, 2019, 11(Suppl 5): S766-S770.
11.	洪若鵬, 鄭斌, 鄭煒, 等. 2.5 野淋巴結清掃在高齡與非高齡食管癌患者手術治療中的對比研究. 中華胸部外科電子雜志, 2019, 6(2): 82-90.
12.	鄭斌, 許錦鑫, 吳培訓, 等. 密閉式單孔胸腹腔鏡聯合食管癌根治術的應用價值. 中華消化外科雜志, 2019, 18(3): 270-273.
13.	Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: Retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. Cardiothorac Surg, 2013, 8: 153.
14.	嚴小鵬, 商澎, 史愛華, 等. 磁外科學體系的探索與建立. 科學通報, 2019, 64(8): 815-826.
15.	Best SL, Bergs R, Scott DJ, et al. Solo surgeon laparo-endoscopic single site nephrectomy facilitated by new generation magnetically anchored and guided systems camera. J Endourol, 2012, 26(3): 214-218.
16.	Padilla BE, Dominguez G, Millan C, et al. Initial experience with magnet-assisted single trocar appendectomy in children. J Laparoendosc Adv Surg Tech A, 2013, 23(5): 463-466.
17.	Rivas H, Robles I, Riquelme F, et al. Magnetic surgery: Results from first prospective clinical trial in 50 patients. Ann Surg, 2018, 267(1): 88-93.
18.	李艷, 馬鋒, 王浩華, 等. 磁錨定牽引技術及臨床研究進展. 腹腔鏡外科雜志, 2019, 24(10): 786-789.
19.	Zhu H, Shang Y, Ma T, et al. 10-mm laparo-endoscopic single-site cholecystectomy using multiple magnetically anchored and controlled instruments. J Surg Res, 2019, 239: 166-172.
20.	Haskins IN, Strong AT, Allemang MT, et al. Magnetic surgery: First U.S. experience with a novel device. Surg Endosc, 2018, 32(2): 895-899.
21.	Cadeddu J, Fernandez R, Desai M, et al. Novel magnetically guided intra-abdominal camera to facilitate laparoendoscopic single-site surgery: initial human experience. Surg Endosc, 2009, 23(8): 1894-1899.
22.	Rodríguez Sánchez J, Rodríguez Sánchez E, de la Santa Belda E, et al. Electromagnetic assisted endoscopic submucosal dissection is more efficient than water-jet assisted and conventional ESD in experimental model. Endosc Int Open, 2018, 6(4): E498-E504.
23.	Cho YB, Park CH, Kim HC, et al. Single-incision laparoscopic surgery in a survival animal model using a transabdominal magnetic anchoring system. Surg Endosc, 2011, 25(12): 3934-3938.
24.	Davis M, Davalos G, Ortega C, et al. Magnetic liver retraction: An incision-less approach for less invasive bariatric surgery. Obes Surg, 2019, 29(3): 1068-1073.
25.	嚴小鵬, 李益行, 付軍科, 等. 磁錨定技術輔助胸腔鏡肺楔形切除術三例. 中國胸心血管外科臨床雜志, 2020, 27(2): 228-229.

1. 譚黎杰, 唐漢. 食管癌腔鏡和開放手術選擇的評價. 中華胃腸外科雜志, 2016, 19(9): 971-974.
2. 龔太乾. 微創食管切除術術式演變與個體化選擇. 轉化醫學雜志, 2019, 8(5): 262-265.
3. Zheng W, Zhu Y, Guo CH, et al. Esophageal suspension method in scavenging peripheral lymph nodes of the left recurrent laryngeal nerve in thoracic esophageal carcinoma through semi-prone-position thoracoscopy. J Cancer Res Ther, 2014, 10(4): 985-990.
4. Oshikiri T, Yasuda T, Harada H, et al. A new method (the "Bascule method") for lymphadenectomy along the left recurrent laryngeal nerve during prone esophagectomy for esophageal cancer. Surg Endosc, 2015, 29(8): 2442-2450.
5. Oshikiri T, Nakamura T, Hasegawa H, et al. Reliable surgical techniques for lymphadenectomy along the left recurrent laryngeal nerve during thoracoscopic esophagectomy in the prone position. Ann Surg Oncol, 2017, 24(4): 1018.
6. 林淼, 沈亞星, 汪灝, 等. 微創食管手術中食管懸吊法清掃左喉返神經旁淋巴結的臨床療效分析. 中國臨床醫學, 2016, 23(4): 484-487.
7. 沈國義, 張奕, 戴益智, 等. 胸腔內食管牽引挑離法在微創食管癌切除術中左側喉返神經旁淋巴結清掃的應用. 中國微創外科雜志, 2018, 18(5): 401-404, 408.
8. Tan JT, Zhong JH, Yang Y, et al. Comparison of postoperative immune function in patients with thoracic esophageal cancer after video-assisted thoracoscopic surgery or conventional open esophagectomy. Int J Surg, 2016, 30: 155-160.
9. 劉清松, 胡偉鵬, 陳龍奇, 等. 單孔胸腔鏡食管癌切除術的現狀與進展. 中華消化外科雜志, 2018, 17(8): 800-803.
10. Cuesta MA. Review of different approaches of the left recurrent laryngeal nerve area for lymphadenectomy during minimally invasive esophagectomy. J Thorac Dis, 2019, 11(Suppl 5): S766-S770.
11. 洪若鵬, 鄭斌, 鄭煒, 等. 2.5 野淋巴結清掃在高齡與非高齡食管癌患者手術治療中的對比研究. 中華胸部外科電子雜志, 2019, 6(2): 82-90.
12. 鄭斌, 許錦鑫, 吳培訓, 等. 密閉式單孔胸腹腔鏡聯合食管癌根治術的應用價值. 中華消化外科雜志, 2019, 18(3): 270-273.
13. Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: Retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. Cardiothorac Surg, 2013, 8: 153.
14. 嚴小鵬, 商澎, 史愛華, 等. 磁外科學體系的探索與建立. 科學通報, 2019, 64(8): 815-826.
15. Best SL, Bergs R, Scott DJ, et al. Solo surgeon laparo-endoscopic single site nephrectomy facilitated by new generation magnetically anchored and guided systems camera. J Endourol, 2012, 26(3): 214-218.
16. Padilla BE, Dominguez G, Millan C, et al. Initial experience with magnet-assisted single trocar appendectomy in children. J Laparoendosc Adv Surg Tech A, 2013, 23(5): 463-466.
17. Rivas H, Robles I, Riquelme F, et al. Magnetic surgery: Results from first prospective clinical trial in 50 patients. Ann Surg, 2018, 267(1): 88-93.
18. 李艷, 馬鋒, 王浩華, 等. 磁錨定牽引技術及臨床研究進展. 腹腔鏡外科雜志, 2019, 24(10): 786-789.
19. Zhu H, Shang Y, Ma T, et al. 10-mm laparo-endoscopic single-site cholecystectomy using multiple magnetically anchored and controlled instruments. J Surg Res, 2019, 239: 166-172.
20. Haskins IN, Strong AT, Allemang MT, et al. Magnetic surgery: First U.S. experience with a novel device. Surg Endosc, 2018, 32(2): 895-899.
21. Cadeddu J, Fernandez R, Desai M, et al. Novel magnetically guided intra-abdominal camera to facilitate laparoendoscopic single-site surgery: initial human experience. Surg Endosc, 2009, 23(8): 1894-1899.
22. Rodríguez Sánchez J, Rodríguez Sánchez E, de la Santa Belda E, et al. Electromagnetic assisted endoscopic submucosal dissection is more efficient than water-jet assisted and conventional ESD in experimental model. Endosc Int Open, 2018, 6(4): E498-E504.
23. Cho YB, Park CH, Kim HC, et al. Single-incision laparoscopic surgery in a survival animal model using a transabdominal magnetic anchoring system. Surg Endosc, 2011, 25(12): 3934-3938.
24. Davis M, Davalos G, Ortega C, et al. Magnetic liver retraction: An incision-less approach for less invasive bariatric surgery. Obes Surg, 2019, 29(3): 1068-1073.
25. 嚴小鵬, 李益行, 付軍科, 等. 磁錨定技術輔助胸腔鏡肺楔形切除術三例. 中國胸心血管外科臨床雜志, 2020, 27(2): 228-229.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Experimental study of magnetic anchoring and traction device assisting thoracoscopic esophagectomy

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