磁外科技术在创伤领域的应用研究及展望

Application research and prospect of magnetic surgery techniques in trauma

随着磁力和磁性材料的迅速发展及其在医学中的应用,外科领域产生了一个崭新的分支——磁外科.磁外科包括磁压榨、磁锚定、磁导航、磁示踪、磁悬浮等多项技术,在创伤救治领域中显示出极大优势.本文详细阐述磁相关技术的原理及优势,综述磁力和磁性材料在消化道重建、创伤后压迫止血、血管快速重建、骨折内固定等创伤治疗领域的研究现状和优缺点,并介绍磁外科技术在创伤领域的应用前景.

With the rapid development of magnetic force and magnetic materials and their application in the medicine, a novel field of magnetic surgery has been created. Magnetic surgery uses magnetic technology for surgical treatment, including magnetic anastomosis technology, magnetic anchoring technology, magnetic navigation technology, magnetic tracer technology,magnetic levitation technology and other branches. Research on magnetic surgery has lasted for more than 40 years, and its development process has been divided into three stages: The experimental demonstration stage, the free exploration stage,and the department construction stage.In 2018, Professor Yi Lü discussed the development of magnetic surgery with foreign experts from worldwide, including the United States, South Korea and Czech Republic, and they signed the "International Development of Magnetic SurgeryXi’an Consensus". This is a milestone in the development of international magnetic surgery. It has established China’s role as a leader in the field of international magnetic surgery. Magnetic surgery has begun to enter a scientific, standardized, indepth and comprehensive department construction stage. Trauma refers to the damage to the structural integrity of the body caused by the mechanical force transmitted to the human body. Incidence of trauma is increasing worldwide, with mortality accounting for about 7% of the diseases. High-tech local wars will lead to more complicated traumatic wounds and more difficult treatments. Magnetic surgery technology has shown great advantages in the field of wound treatment.This article elaborates on the principles and advantages of magnetic compression anastomosis, reviews the research status, advantages and disadvantages of magnetic and magnetic materials in the field of trauma treatment such as digestive tract reconstruction, post-traumatic compression hemostasis, rapid reconstruction of blood vessels, and fracture internal fixation, and their application prospects.The advantages of MCA include:(1) The device works safely in a wide range of ages and even in high-risk patients.(2)Patients can be safely discharged from the hospital with the device in place.(3) Nonmagnetic instruments improve the surgeon’s ability to handle the magnets.(4) A mechanism to create immediate patency between the mated magnets would simplify and shorten the procedure. The magnamosis device’s method of slow tissue remodeling without leaving foreign bodies creates a well-formed anastomosis, which may decrease the incidence of anastomotic leaks. Moreover, the simplicity of merely "sticking" the two segments of intestine together can save significant operative time. However, open surgery is not the best way to showcase the merits of magnamosis. In the future, we plan to focus on laparoscopic delivery of the magnamosis device, which currently can be deployed using laparoscopic, endoscopic, radiographic, or hybrid techniques. Moreover, it is scalable, and can be sized and adapted to a variety of intra-luminal anastomoses, including intestinal, urologic, and biliary applications, with wide-reaching implications for the future of surgery.