磁锚定技术辅助腹腔镜阑尾切除术的实验研究

Experimental study of magnetic anchoring technique assisted reduced-port laparoscopic cholecystectomy

目的:验证自行设计加工的磁锚定装置在减戳孔腹腔镜阑尾切除术中应用的可行性。方法:设计加工适用于辅助减戳孔腹腔镜阑尾切除术的磁锚定装置,该装置包括内置抓钳和锚定磁体2个部分。以6只健康雄性Beagle犬为模型,用磁锚定装置代替传统腹腔镜阑尾切除术中的副操作孔抓钳,经主操作孔置入磁锚定内置抓钳并钳夹于阑尾尖部,体外放置锚定磁体,锚定磁体与内置抓钳的靶磁体相吸,移动锚定磁体即可改变内置抓钳的牵拉方向,从而有效牵拉暴露手术术野,完成减戳孔腹腔镜阑尾切除手术。记录手术操作时间、术中出血量,评价利用磁锚定装置进行阑尾切除时操作的安全性和可行性。结果:6只Beagle犬均顺利完成磁锚定技术辅助减戳孔腹腔镜阑尾切除,手术时间27~38 min,出血量均小于10 ml,术后实验犬状态良好,未出现并发症。结论:磁锚定装置用于减戳孔腹腔镜阑尾切除手术操作简单、安全可行,在相关设计进一步优化基础上,可尝试或试验性用于临床。

Objective To verify the feasibility of a self-designed magnetic anchoring device in laparoscopic appendectomy.Methods A magnetic anchoring device was designed and manufactured to facilitate assisted reduced-port laparoscopic appendectomy,which was composed of two parts of internal grasper and anchoring magnet.Six healthy male Beagle dogs were used as the models.The magnetic anchoring device was used to replace the gripper at the auxiliary operating hole.The device had its internal grasper drawn through the main operating hole to clamp the tip of the appendix,and the anchoring magnet was placed in vitro.The drawing direction of the internal grasper was changed by moving the magnet attracted with the target magnet of the grasper,so that the operative field could be exposed adequately to facilitate assisted reduced-port laparoscopic appendectomy.The operation time and bleeding volume were recorded,and the safety and feasibility of appendectomy with magnetic anchoring device were evaluated.Results All the 6 Beagle dogs successfully completed the appendectomy assisted by magnetic anchoring technique.The operation time was restrained between 27 and 38 min,and the amount of bleeding was less than 10 ml.Conclusion The magnetic anchorage device is simple,safe and feasible for laparoscopic appendectomy.After further accumulating more experimental data and further optimizing the relevant design,it can be approved for trial or experimental use in clinical practice.