Clinical feasibility of laparoscopic left lateral segment liver resection with magnetic anchor technique:The first clinical study from China

BACKGROUND Magnetic anchor technique(MAT)has been applied in laparoscopic cholecystectomy and laparoscopic appendectomy,but has not been reported in laparoscopic partial hepatectomy.AIM To evaluate the feasibility of the MAT in laparoscopic left lateral segment liver resection.METHODS Retrospective analysis was conducted on the clinical data of eight patients who underwent laparoscopic left lateral segment liver resection assisted by MAT in our department from July 2020 to November 2021.The Y-Z magnetic anchor devices(Y-Z MADs)was independently designed and developed by the author of this paper,which consists of the anchor magnet and magnetic grasping apparatus.Surgical time,intraoperative blood loss,intraoperative accidents,operator experience,postoperative incision pain score,postoperative complications,and other indicators were evaluated and analyzed.RESULTS All eight patients underwent a MAT-assisted laparoscopic left lateral segment liver resection,including three patients undertaking conventional 5-port and five patients having a transumbilical single-port operation.The mean operation time was 138±34.32 min(range 95-185 min)and the mean intraoperative blood loss was 123±88.60 mL(range 20-300 mL).No adverse events occurred during the operation.The Y-Z MADs showed good workability and maneuverability in both tissue and organ exposure.In particular,the operators did not experience either a“chopstick”or“sword-fight”effect in the single-port laparoscopic operation.CONCLUSION The results show that the MAT is safe and feasible for laparoscopic left lateral segment liver resection,especially,exhibits its unique abettance for transumbilical single-port laparoscopic left lateral segment liver resection.

Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures

Endoscopic submucosal dissection(ESD) is a wellestablished, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection(MAGESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's "second hand". Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology.

A Localization Algorithm Using a Mobile Anchor Node Based on Region Determination in Underwater Wireless Sensor Networks

At present, most underwater positioning algorithms improve the positioning accuracy by increasing the number of anchor nodes which resulting in the increasing energy consumption. To solve this problem, the paper proposes a localization algorithm assisted by mobile anchor node and based on region determination(LMRD), which not only improves the positioning accuracy of nodes positioning but also reduces the energy consumption. This algorithm is divided into two stages: region determination stage and location positioning stage. In the region determination stage, the target region is divided into several sub-regions by the region division strategy with the smallest overlap rate which can reduce the number of virtual anchor nodes and lock the target node to a sub-region, and then through the planning of mobile nodes to optimize the travel path, reduce the moving distance, and reduce system energy consumption. In the location positioning stage, the target node location can be calculated using the HILBERT path planning and trilateration. The simulation results show that the proposed algorithm can improve the positioning accuracy when the energy consumption is reduced.

Miniature magnetically anchored and controlled camera system for trocar-less laparoscopy

AIM To design a miniature magnetically anchored and controlled camera system to reduce the number of trocars which are required for laparoscopy.METHODS The system consists of a miniature magnetically anchored camera with a 30° downward angle, an external magnetically anchored unit, and a vision output device. The camera weighs 12 g, measures Φ10.5 mm × 55 mm and has two magnets, a vision model, a light source, and a metal hexagonal nut. To test the prototype, the camera was inserted through a 12-mm conventional trocar in an ex vivo real liver laparoscopic training system. A trocar-less laparoscopic cholecystectomy was performed 6 times using a 12-mm and a 5-mm conventional trocar. In addition, the same procedure was performed in four canine models.RESULTS Both procedures were successfully performed using only two conventional laparoscopic trocars. The cholecystectomy was completed without any major complication in 42 min(38-45 min) in vitro and in 50 min(45-53 min) using an animal model. This camera was anchored and controlled by an external unit magnetically anchored on the abdominal wall. The camera could generate excellent image. with no instrument collisions.CONCLUSION The camera system we designed provides excellent optics and can be easily maneuvered. The number of conventional trocars is reduced without adding technical difficulties.

Penetration Depth of Torpedo Anchor in Two-Layered Cohesive Soil Bed by Free Fall

The penetration depth of torpedo anchor in two-layered soil bed was experimentally investigated. A total of 177 experimental data were obtained in laboratory by varying the undrained shear strength of the two-layered soil and the thickness of the top soil layer. The geometric parameters of the anchor and the soil properties(the liquid limit, plastic limit, specific gravity, undrained shear strength, density, and water content) were measured. Based on the energy analysis and present test data, an empirical formula to predict the penetration depth of torpedo anchor in two-layered soil bed was proposed. The proposed formula was extensively validated by laboratory and field data of previous researchers. The results were in good agreement with those obtained for two-layered and single-layered soil bed.Finally, a sensitivity analysis on the parameters in the formula was performed.

Free-Fall Penetration Behaviors of A New Dynamically Installed Plate Anchor in Marine Clay

A new dynamically installed plate anchor, the Flying Wing Anchor~?, has been developed as a sustainable anchor concept for deep-water offshore wind turbines. The anchor is firstly installed by free-fall penetration and then followed by drag embedment. If the anchor is subjected to environmental loads, it dives deeper to mobilize a higher capacity. This study presents a series of free-fall penetration tests with model anchors in different weights to assess the anchor behavior during the free-fall penetration performance in one-layer soil with a constant shear strength profile. Anchor velocities and embedment depths were measured by a magnetometer. An energy-based model and a force-based model were calibrated against the test results of model anchors with different weights. Based on the calibrated force-based model, a series of design charts were developed to estimate the embedment depth of anchors in different sizes and with different impact velocities in various marine clays. The framework to plot design charts presented herein can be potentially applied to other dynamically installed anchors to predict embedment depth in engineering practice.

Study on range interval distance of prestressed anchor bars using update backpropagation neural network

Taking the practical reinforced engineering of a reinforced soil retaining wall as an example, which located in Shandong Province and set on 104 national highway, the stress spread behaviors of the anchor bars in the preforced proceeding were tested. According to the test data, and by use of the update backpropagation (BP) algorithm neural network(NN), the test method and it’s mechanism were studied by the network, then the learning results show the mean square error(MSE) only at the 2 55% level, and the proof testing results show the MSE at 4 38% level (the main aim is to build a NN directly from the in situ test results (the learning phase)). Ipso facto, the learning and adjustment abilities of the NN permit us to develop the test data, subsequently, 36 test data were acquired from the NN. By use of the provide data, as well as the failure situation and carried loading capacity of the retaining wall, finally, the choice the reasonable range interval distance of prestress cement grouting anchor bars were carried out, and the result was 2 m×2 m.

Six-Degree-of-Freedom Measurement of Plate Anchors in Centrifuge by Magnetometers

The six-degree-of-freedom movement of an offshore plate anchor is essential to evaluate anchor performance.As an emerging technology,magnetometer has shown its potential in measuring the six-degree-of-freedom movement of offshore anchors under 1-g model laboratory tests.The paper presents the feasibility of adopting a magnetometer system in geotechnical centrifuge testing.Interference factors that may affect the measuring accuracy of the magnetometer system are investigated.The results demonstrate that the magnetometer system can accurately catch the anchor movement in the soils with the restrictions of:(1)the model anchor was made with stainless steel;(2)the system was placed at least 30 cm away from the side wall of soil model tank;(3)started the measurement when the artificial acceleration by centrifuge was stable.

Epigenetic interventions for brain rejuvenation：anchoring age-related transposons

Highlights：1.Iron and homocysteine accumulation in aging neurons alter genomic methylation.2.The altered methylome reactivates neuronal cell cycle,enabling transposable element mobilization.3.mi R29/p53 axis restores age-related methylation shifts,reactivating neuronal plasticity.4.Augmentation of mi R-29/p53 axis may preempt neurodegenerative disorders.

Animal experimental study on magnetic anchor technique-assisted endoscopic submucosal dissection of early gastric cancer

BACKGROUND Gastric cancer(GC)has high morbidity and mortality.Moreover,because GC has no typical symptoms in the early stages,most cases are already in the advanced stages by the time the symptoms appear,thus resulting in poor prognosis and a low survival rate.Endoscopic submucosal dissection(ESD)can realize the early detection and diagnosis of GC and become the main surgical method for early GC.However,ESD has a steep learning curve and high technical skill requirements for endoscopists,which is not conducive to its widespread implementation and advancement.Therefore,a series of auxiliary techniques have been derived.AIM To evaluate the safety and efficacy of magnetic anchor technique(MAT)-assisted ESD in early GC.METHODS This was an ex vivo animal experiment.The experimental models were the isolated stomachs of pigs,which were divided into two groups,namely the study group(n=6)with MAT-assisted ESD and the control group(n=6)with traditional ESD.Comparing the total surgical time,incidence of surgical complications,complete mucosal resection rate,specimen size,and the scores of endoscopist’s satisfaction with the procedure reflected their feelings about convenience during the surgical procedure between the two groups.The magnetic anchor device for auxiliary ESD in the study group comprised three parts,an anchor magnet(AM),a target magnet(TM),and a soft tissue clip.Under gastroscopic guidance,the soft tissue clip and the TM were delivered to the pre-marked mucosal lesion through the gastroscopic operating hole.The soft tissue clip and the TM were connected by a thin wire through the TM tail structure.The soft tissue clip was released by manipulating the operating handle of the soft tissue clip in a way that the soft tissue clip and the TM were fixed to the lesion mucosa.In vitro,ESD is aided by maneuvering the AM such that the mucosal dissection surface is exposed.RESULTS The total surgical time was shorter in the study group than in the control group(26.57±0.19 vs 29.97±0.28,P<0.001),and the scores of endoscopist’s satisfaction with the procedure were higher in the study group than in the control group(9.53±0.10 vs 8.00±0.22,P<0.001).During the operation in the study group,there was no detachment of the soft tissue clip and TM and no mucosal tearing.The magnetic force between the AM and TM provided good mucosal exposure and sufficient tissue tension for ESD.The mucosal lesion was completely peeled off,and the operation was successful.There were no significant differences in the incidence of surgical complications(100%vs 83.3%),complete mucosal resection rate(100%vs 66.7%,P=0.439),and specimen size(2.44±0.04 cm vs 2.49±0.02,P=0.328)between the two groups.CONCLUSION MAT-ESD is safe and effective for early GC.It provides a preliminary basis for subsequent internal animal experiments and clinical research.

Mechanical responses of anchoring structure under triaxial cyclic loading

Dynamic load on anchoring structures(AS)within deep roadways can result in cumulative damage and failure.This study develops an experimental device designed to test AS under triaxial loads.The device enables the investigation of the mechanical response,failure mode,instability assessment criteria,and anchorage effect of AS subjected to combined cyclic dynamic-static triaxial stress paths.The results show that the peak bearing strength is positively correlated with the anchoring matrix strength,anchorage length,and edgewise compressive strength.The bearing capacity decreases significantly when the anchorage direction is severely inclined.The free face failure modes are typically transverse cracking,concave fracturing,V-shaped slipping and detachment,and spallation detachment.Besides,when the anchoring matrix strength and the anchorage length decrease while the edgewise compressive strength,loading rate,and anchorage inclination angle increase,the failure intensity rises.Instability is determined by a negative tangent modulus of the displacement-strength curve or the continued deformation increase against the general downward trend.Under cyclic loads,the driving force that breaks the rock mass along the normal vector and the rigidity of the AS are the two factors that determine roadway stability.Finally,a control measure for surrounding rock stability is proposed to reduce the internal driving force via a pressure relief method and improve the rigidity of the AS by full-length anchorage and grouting modification.

Mechanism of high-preload support based on the NPR anchor cable in layered soft rock tunnels

The control of large deformation problems in layered soft rock tunnels needs to solve urgently.The roof problem is particularly severe among the deformation issues in tunnels.This study first analyzes the asymmetric deformation modes in layered soft rock tunnels with large deformations.Subsequently,we construct a mechanical model under ideal conditions for controlling the roof of layered soft rock tunnels through high preload with the support of NPR anchor cables.The prominent roles of long and short NPR anchor cables in the support system are also analyzed.The results indicate the significance of high preload in controlling the roof of layered soft rock tunnels.The short NPR anchor cables effectively improve the integrity of the stratified soft rock layers,while the long NPR anchor cables effectively mobilize the self-bearing capacity of deep-stable rock layers.Finally,the high-preload support method with NPR anchor cables is validated to have a good effect on controlling large deformations in layered soft rock tunnels through field monitoring data.

Artificial Neural Network Model for Predicting Ultimate Tensile Capacity of Adhesive Anchors

To predict the tensile capacity of adhesive anchors, a multilayered feed-forward neural network trained with the back-propagation algorithm is constructed. The ANN model have 5 inputs, including the compressive strength of concrete, tensile strength of concrete, anchor diameter, hole diameter, embedment of anchors, and ultimate load. The predictions obtained from the trained ANN show a good agreement with the experiments. Meanwhile, the predicted ultimate tensile capacity of anchors is close to the one calculated from the strength formula of the combined cone-bond failure model.

Magnetic anchor technique assisted endoscopic submucosal dissection for early esophageal cancer

BACKGROUND Esophageal cancer has high incidence globally and is often diagnosed at an advanced stage.With the widespread application of endoscopic technologies,the need for early detection and diagnosis of esophageal cancer has gradually been realized.Endoscopic submucosal dissection(ESD)has become the standard of care for managing early tumors of the esophagus,stomach,and colon.However,due to the steep learning curve,difficult operation,and technically demanding nature of the procedure,ESD has currently been committed to the development of various assistive technologies.AIM To explore the feasibility and applicability of magnetic anchor technique(MAT)-assisted ESD for early esophageal cancer.METHODS Isolated pig esophagi were used as the experimental model,and the magnetic anchor device was designed by us.The esophagi used were divided into two groups,namely the operational and control groups,and 10 endoscopists completed the procedure.The two groups were evaluated for the following aspects:The total operative time,perforation rate,rate of whole mucosal resection,diameter of the peering mucosa,and scores of endoscopists’feelings with the procedure,including the convenience,mucosal surface exposure degree,and tissue tension.In addition,in the operational group,the soft tissue clip and the target magnet(TM)were connected by a thin wire through a small hole at the tail end of the TM.Under gastroscopic guidance,the soft tissue clip was clamped to the edge of the lesioned mucosa,which was marked in advance.By changing the position of the anchor magnet(AM)outside the esophagus,the pulling force and pulling direction of the TM could be changed,thus exposing the mucosal peeling surface and assisting the ESD.RESULTS Herein,each of the two groups comprised 10 isolated esophageal putative mucosal lesions.The diameter of the peering mucosa did not significantly differ between the two groups(2.13±0.06 vs 2.15±0.06,P=0.882).The total operative time was shorter in the operational group than in the control group(17.04±0.22 min vs 21.94±0.23 min,P<0.001).During the entire experiment,the TM remained firmly connected with the soft tissue clip and did not affect the opening,closing,and release of the soft tissue clip.The interaction between the TM and AM could provide sufficient tissue tension and completely expose the mucosa,which greatly assists the surgeon with the operation.There was no avulsion of the mucosa,and mucosal lesions were intact when peeled.Therefore,the scores of endoscopists’feelings were higher in the operational group than in the control group in terms of the convenience(9.22±0.19 vs 8.34±0.15,P=0.002),mucosal surface exposure degree(9.11±0.15 vs 8.25±0.12,P<0.001),and tissue tension(9.35±0.13 vs 8.02±0.17,P<0.001).The two groups did not significantly differ in the perforation rate and rate of whole mucosal resection.CONCLUSION We found MAT-assisted ESD safe and feasible for early esophageal cancer.It could greatly improve the endoscopic operation experience and showed good clinical application prospects.

Simulation experiment on anti-penetration capability of anchored rock mass

In order to solve the problem of experimental research on the penetration process of projectile into anchored rock mass, we derived the essential similarity conditions for the physical simulation experi- ment according to the similarity theory, carried out the experiment on the penetration process of a kind of penetrating bomb into the anchored rock mass of type III, and compared the experimental results with the values computed by the professional Young's empirical formula. The test results show that the phys- ical simulation experiment can represent the actual penetration process of projectile into anchored rock mass. The research method proposed in this paper provides technical support for the experimental research on the design and reconstruction of underground protection works.

Anchoring mechanical characteristics of Ductile-Expansion bolt

The application of ductile rock bolts has been a crucial method for solving the problems of large deformations,energy absorption and stability control issues in deep rock masses.To study the anchoring mechanism of the key expansive structure,this paper proposes a novel type of bolt—the Ductile-Expansion bolt,and conducts research on anchoring mechanics,energy absorption characteristics,and failure modes of the bolt.In addition,this paper defines the concept of load-volume ratio of metal rock bolts and proves the Ductile-Expansion bolt is capable of better improving the unit volume bearing capacity of the bolt material.Furthermore,laboratory and field tests verify the Ductile-Expansion bolt had better anchoring effect than the traditional rebar bolt,with the expansion structure favorably enhancing the ductility and energy absorption performance of the bolt.Finally,this paper microscopically analyzes the crack propagation and distribution morphology of the bolts by establishing a 3D coupled numerical model based on FDM-DEM.Numerical results illustrate the interface at the variable diameter of the Ductile-Expansion bolt serves as the transition zone between high and low stress levels.The expansion structure can impose radial compression on the medium around the bolt,which can improve the bolt anchorage performance.

Case study on the mechanics of NPR anchor cable compensation for large deformation tunnel in soft rock in the Transverse Mountain area,China

A study was conducted to analyze the deformation mechanism of strongly weathered quartz schist in the Daliangshan Tunnel,located in the western Transverse Mountain area.A large deformation problem was experienced during the tunnel construction.To mitigate this problem,a support system was designed incorporating negative Poisson ratio(NPR)anchor cables with negative Poisson ratio effect.Physical model experiments,field experiments,and numerical simulation experiments were conducted to investigate the compensation mechanical behavior of NPR anchor cables.The large deformations of soft rocks in the Daliangshan Tunnel are caused by a high ground stress,a high degree of joint fracture development,and a high degree of surrounding rock fragmentation.A compensation mechanics support system combining long and short NPR anchor cables was suggested to provide sufficient counter-support force(approximately 350 kN)for the surrounding rock inside the tunnel.Comparing the NPR anchor cable support system with the original support system used in the Daliangshan tunnel showed that an NPR anchor cable support system,combining cables of 6.3 m and 10.3 m in length,effectively prevented convergence of surrounding rock deformation,and the integrated settlement convergence value remained below 300 mm.This study provides an effective scientific basis for resolving large deformation problems in deeply buried soft rocks in western transverse mountain areas.

Seismic stability of expansive soil slopes reinforced by anchor cables using a modified horizontal slice method

Earthquake-induced slope failures are common occurrences in engineering practice and pre-stressed anchor cables are an effective technique in maintaining slope stability,especially in areas that are prone to earthquakes.Furthermore,the soil at typical engineering sites also exhibit unsaturated features.Explicit considerations of these factors in slope stability estimations are crucial in producing accurate results.In this study,the seismic responses of expansive soil slopes stabilized by anchor cables is studied in the realm of kinematic limit analysis.A modified horizontal slice method is proposed to semi-analytically formulate the energy balance equation.An illustrative slope is studied to demonstrate the influences of suction,seismic excitations and anchor cables on the slope stability.The results indicate that the stabilizing effect of soil suction relates strongly to the seismic excitation and presents a sine shape as the seismic wave propagates.In higher and steeper slopes,the stabilizing effect of suction is more evident.The critical slip surface tends to be much more shallow as the seismic wave approaches the peak and vice versa.

Three-dimensional limit variation analysis on the ultimate pullout capacity of the anchor cables based on the Hoek-Brown failure criterion

Only simplified two-dimensional model and a single failure mode are adopted to calculate the ultimate pullout capacity(UPC)of anchor cables in most previous research.This study focuses on a more comprehensive combination failure mode that consists of bond failure of an anchorage body and failure of an anchored rock mass.The three-dimensional ultimate pullout capacity of the anchor cables is calculated based on the Hoek-Brown failure criterion and variation analysis method.The numerical solution for the curvilinear function in fracture plane is obtained based on the finite difference theory,which more accurately reflects the failure state of the anchor cable,as opposed to that being assumed in advance.The results reveal that relying solely on a single failure mode for UPC calculations has limitations,as changes in parameter values not only directly impact the UPC value but also can alter the failure model and thus the calculation method.

Mechanical behavior of 2G NPR bolt anchored rock samples under static disturbance loading

The deep mining of coal resources is accompanied by severe environmental challenges and various potential engineering hazards.The implementation of NPR(negative Poisson's ratio)bolts are capable of controlling large deformations in the surrounding rock effectively.This paper focuses on studying the mechanical properties of the NPR bolt under static disturbance load.The deep nonlinear mechanical experimental system was used to study the mechanical behavior of rock samples with different anchored types(unanchored/PR anchored/2G NPR anchored)under static disturbance load.The whole process of rock samples was taken by high-speed camera to obtain the real-time failure characteristics under static disturbance load.At the same time,the acoustic emission signal was collected to obtain the key characteristic parameters of acoustic emission such as acoustic emission count,energy,and frequency.The deformation at the failure of the samples was calculated and analyzed by digital speckle software.The findings indicate that the failure mode of rock is influenced by different types of anchoring.The peak failure strength of 2G NPR bolt anchored rock samples exhibits an increase of 6.5%when compared to the unanchored rock samples.The cumulative count and cumulative energy of acoustic emission exhibit a decrease of 62.16%and 62.90%,respectively.The maximum deformation of bearing capacity exhibits an increase of 59.27%,while the failure time demonstrates a delay of 42.86%.The peak failure strength of the 2G NPR bolt anchored ones under static disturbance load exhibits an increase of 5.94%when compared to the rock anchored by PR(Poisson's ratio)bolt.The cumulative count and cumulative energy of acoustic emission exhibit a decrease of 47.16%and 43.86%,respectively.The maximum deformation of the bearing capacity exhibits an increase of 50.43%,and the failure time demonstrates a delay of 32%.After anchoring by 2G NPR bolt,anchoring support effectively reduces the risk of damage caused by static disturbance load.These results demonstrate that the support effect of 2G NPR bolt materials surpasses that of PR bolt.