Directable traction systems and methods
Inventors
Assignees
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Publication Number
US-11020137-B2
Publication Date
2021-06-01
Expiration Date
Abstract
Described here are methods, systems, and devices, useful for minimally invasive surgical procedures. The methods may include introducing a grasper through an opening into an abdominal cavity, grasping a portion of a left lobe of a liver with the grasper, rotating the grasper towards a control element located outside the abdominal cavity by applying a magnetic field to the grasper across a body wall, and moving the control element over a set of ribs such that the liver bends into a folded configuration.
Core Innovation
The invention relates to minimally invasive surgery using remote tissue traction with a detachable magnetic grasper introduced through an opening into an abdominal cavity. The grasper grasps specified portions of the liver and is rotated towards a magnetic control element located outside the abdominal cavity. A magnetic field is applied to the grasper across a body wall so that external movement of the magnetic control element influences the grasper and the grasped liver tissue.
By moving the magnetic control element over a set of ribs, the liver bends into a folded configuration. This fold vacates space within the abdominal cavity, enabling accessing and visualizing a stomach and enabling gastric procedures. The described liver targeting includes grasping a left-lateral portion of segment II and an inferior portion of segment III of a left lobe, as well as grasping inferior portions of segments IV–VI of a right lobe.
The document further describes a workflow that includes performing a sleeve gastrectomy and cutting a pylorus from a duodenum while using the magnetic traction to fold and reposition the left and right lobes. Variations described include using an optical sensor to visualize a vacated abdominal space and performing the gastric procedure while the liver forms the fold.
Claims Coverage
The document includes three independent method claims directed to introducing a magnetic grasper into an abdominal cavity, magnetically controlling liver tissue via an externally located magnetic control element, and bending the liver into a folded configuration. The inventive features number from 4 to 6 across the independent claims, with additional dependent refinements focused on vacated-space accessing and specifying gastric procedure steps.
Magnetic grasper introduction into abdominal cavity
Introducing a grasper through an opening into an abdominal cavity.
Liver grasping for defined segments or lobe
Grasping a portion of one or more of a left-lateral portion of segment II and an inferior portion of segment III of a left lobe of a liver with the grasper; or grasping an inferior portion of one or more of segments IV, V, and VI of a right lobe of a liver with the grasper; or grasping a portion of a left lobe of a liver and grasping a portion of a right lobe of a liver with the grasper.
External magnetic control element rotation of grasper
Rotating the grasper towards a magnetic control element located outside the abdominal cavity; and applying a magnetic field to the grasper across a body wall.
Rib-tracked movement to fold liver
Moving the magnetic control element over a set of ribs such that the liver bends into a folded configuration; and for claim 18, moving the magnetic control element over the set of ribs such that the right lobe of the liver bends into a folded configuration after applying the magnetic field to the right-lobe grasped portion.
Gastric procedure and pylorus cutting
Performing a sleeve gastrectomy; and cutting a pylorus from a duodenum.
Accessing vacated space created by liver movement
Accessing a space within an abdominal cavity that becomes vacated by the grasped portion of the liver.
Across the independent claims, the core claim coverage centers on magnetic remote traction: introducing a grasper into an abdominal cavity, grasping specified liver portions, rotating the grasper toward an external magnetic control element, applying a magnetic field across a body wall, and moving the magnetic control element over ribs to bend the liver into a folded configuration. Dependent refinements additionally recite accessing a vacated abdominal space and specifying gastric procedure steps.
Stated Advantages
Enables accessing and visualizing a stomach by vacating space in the abdominal cavity through bending the liver into a folded configuration.
Enables gastric procedures including performing a sleeve gastrectomy while using magnetic liver folding to create procedural access.
Documented Applications
Performing gastric procedures including gastric bypass, sleeve gastrectomy, gastric band, and biliopancreatic diversion with duodenal switch, including gastric cancer resection procedures, using the magnetic traction approach that folds and repositions the liver to vacate space.
Bariatric/surgical workflow using biliopancreatic diversion with duodenal switch including sleeve gastrectomy and pylorus cutting from a duodenum using the magnetic liver fold configuration.
Accessing and visualizing a stomach within the abdominal cavity by using a vacated space created by bending the liver into a folded configuration, including using an optical sensor for visualization.
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