Magnetic instruments for laparoscopic surgery have the potential to enhance triangulation and reduce invasiveness, as they can be rearranged inside the abdominal cavity and do not need a dedicated port during the procedure. Onboard actuators can be used to achieve a controlled and repeatable motion at the interface with the tissue. However, actuators that can fit through a single laparoscopic incision are very limited in power and do not allow performance of surgical tasks such as lifting an organ. In this study, we present a tissue retractor based on local magnetic actuation (LMA). This approach combines two pairs of magnets, one providing anchoring and the other transferring motion to an internal mechanism connected to a retracting lever. Design requirements were derived from clinical considerations, while finite element simulations and static modeling were used to select the permanent magnets, set the mechanism parameters, and predict the lifting and supporting capabilities of the tissue retractor. A three-tier validation was performed to assess the functionality of the device. First, the retracting performance was investigated via a benchtop experiment, by connecting an increasing load to the lever until failure occurred, and repeating this test for different intermagnetic distances. Then, the feasibility of liver resection was studied with an ex vivo experiment, using porcine hepatic tissue. Finally, the usability and the safety of the device were tested in vivo on an anesthetized porcine model. The developed retractor is 154 mm long, 12.5 mm in diameter, and weights 39.16 g. When abdominal wall thickness is 2 cm, the retractor is able to lift more than ten times its own weight. The model is able to predict the performance with a relative error of 9.06 ± 0.52%. Liver retraction trials demonstrate that the device can be inserted via laparoscopic access, does not require a dedicated port, and can perform organ retraction. The main limitation is the reduced mobility due to the length of the device. In designing robotic instrument for laparoscopic surgery, LMA can enable the transfer of a larger amount of mechanical power than what is possible to achieve by embedding actuators on board. This study shows the feasibility of implementing a tissue retractor based on this approach and provides an illustration of the main steps that should be followed in designing a LMA laparoscopic instrument.
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March 2015
Research-Article
Laparoscopic Tissue Retractor Based on Local Magnetic Actuation
Nicolò Garbin,
Nicolò Garbin
STORM Lab,
Department of Mechanical Engineering,
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
e-mail: nicolo.garbin.1@vanderbilt.edu
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
e-mail: nicolo.garbin.1@vanderbilt.edu
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Christian Di Natali,
Christian Di Natali
STORM Lab,
Department of Mechanical Engineering,
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
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Jacopo Buzzi,
Jacopo Buzzi
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
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Elena De Momi,
Elena De Momi
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
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Pietro Valdastri
Pietro Valdastri
1
STORM Lab,
Department of Mechanical Engineering,
e-mail: p.valdastri@vanderbilt.edu
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
e-mail: p.valdastri@vanderbilt.edu
1Corresponding author.
Search for other works by this author on:
Nicolò Garbin
STORM Lab,
Department of Mechanical Engineering,
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
e-mail: nicolo.garbin.1@vanderbilt.edu
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
e-mail: nicolo.garbin.1@vanderbilt.edu
Christian Di Natali
STORM Lab,
Department of Mechanical Engineering,
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
Jacopo Buzzi
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
Elena De Momi
Department of Electronic, Information
and Biomedical Engineering,
Politecnico di Milano,
and Biomedical Engineering,
Politecnico di Milano,
Milano 20133
, Italy
Pietro Valdastri
STORM Lab,
Department of Mechanical Engineering,
e-mail: p.valdastri@vanderbilt.edu
Department of Mechanical Engineering,
Vanderbilt University
,Nashville, TN 37212
e-mail: p.valdastri@vanderbilt.edu
1Corresponding author.
Manuscript received May 14, 2014; final manuscript received September 15, 2014; published online November 14, 2014. Assoc. Editor: Carl Nelson.
J. Med. Devices. Mar 2015, 9(1): 011005 (10 pages)
Published Online: March 1, 2015
Article history
Received:
May 14, 2014
Revision Received:
September 15, 2014
Online:
November 14, 2014
Citation
Garbin, N., Di Natali, C., Buzzi, J., De Momi, E., and Valdastri, P. (March 1, 2015). "Laparoscopic Tissue Retractor Based on Local Magnetic Actuation." ASME. J. Med. Devices. March 2015; 9(1): 011005. https://doi.org/10.1115/1.4028658
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