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

1.	谭黎杰, 唐汉. 食管癌腔镜和开放手术选择的评价. 中华胃肠外科杂志, 2016, 19(9): 971-974.
2.	龚太乾. 微创食管切除术术式演变与个体化选择. 转化医学杂志, 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, 沈亚星, 汪灏, 等. 微创食管手术中食管悬吊法清扫左喉返神经旁淋巴结的临床疗效分析. 中国临床医学, 2016, 23(4): 484-487.
7.	沈国义, 张奕, 戴益智, 等. 胸腔内食管牵引挑离法在微创食管癌切除术中左侧喉返神经旁淋巴结清扫的应用. 中国微创外科杂志, 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.	刘清松, 胡伟鹏, 陈龙奇, 等. 单孔胸腔镜食管癌切除术的现状与进展. 中华消化外科杂志, 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.	洪若鹏, 郑斌, 郑炜, 等. 2.5 野淋巴结清扫在高龄与非高龄食管癌患者手术治疗中的对比研究. 中华胸部外科电子杂志, 2019, 6(2): 82-90.
12.	郑斌, 许锦鑫, 吴培训, 等. 密闭式单孔胸腹腔镜联合食管癌根治术的应用价值. 中华消化外科杂志, 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.	严小鹏, 商澎, 史爱华, 等. 磁外科学体系的探索与建立. 科学通报, 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.	李艳, 马锋, 王浩华, 等. 磁锚定牵引技术及临床研究进展. 腹腔镜外科杂志, 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.	严小鹏, 李益行, 付军科, 等. 磁锚定技术辅助胸腔镜肺楔形切除术三例. 中国胸心血管外科临床杂志, 2020, 27(2): 228-229.

1. 谭黎杰, 唐汉. 食管癌腔镜和开放手术选择的评价. 中华胃肠外科杂志, 2016, 19(9): 971-974.
2. 龚太乾. 微创食管切除术术式演变与个体化选择. 转化医学杂志, 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, 沈亚星, 汪灏, 等. 微创食管手术中食管悬吊法清扫左喉返神经旁淋巴结的临床疗效分析. 中国临床医学, 2016, 23(4): 484-487.
7. 沈国义, 张奕, 戴益智, 等. 胸腔内食管牵引挑离法在微创食管癌切除术中左侧喉返神经旁淋巴结清扫的应用. 中国微创外科杂志, 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. 刘清松, 胡伟鹏, 陈龙奇, 等. 单孔胸腔镜食管癌切除术的现状与进展. 中华消化外科杂志, 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. 洪若鹏, 郑斌, 郑炜, 等. 2.5 野淋巴结清扫在高龄与非高龄食管癌患者手术治疗中的对比研究. 中华胸部外科电子杂志, 2019, 6(2): 82-90.
12. 郑斌, 许锦鑫, 吴培训, 等. 密闭式单孔胸腹腔镜联合食管癌根治术的应用价值. 中华消化外科杂志, 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. 严小鹏, 商澎, 史爱华, 等. 磁外科学体系的探索与建立. 科学通报, 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. 李艳, 马锋, 王浩华, 等. 磁锚定牵引技术及临床研究进展. 腹腔镜外科杂志, 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. 严小鹏, 李益行, 付军科, 等. 磁锚定技术辅助胸腔镜肺楔形切除术三例. 中国胸心血管外科临床杂志, 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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