Magnetic assisted laparoscopic surgery (MALS) is a minimally invasive surgical technique that uses magnetic fields to control surgical instruments. The procedure involves the use of a magnetic controller outside the patient's body to manipulate magnetic-tipped instruments inside the body.

Magnetosurgery, including the magnetic compression technique (MCT) and magnetic anchor technique (MAT), is a novel surgical technology with unique advantages in clinical practice. In 1978, Japanese scholars Obora et al. pioneered research on magnetosurgery with their study on magnetic vascular anastomosis, which utilized a specially-designed magnetic anastomosis device for vascular anastomosis, digestive tract anastomosis, therapeutic fistula, and tracheoesophageal fistula animal model preparation. In 2007, Park et al. introduced the concept of utilizing magnetic force to assist laparoscopic surgery and reduce the number of abdominal wall ports. Since then, various magnetic anchor devices have been developed for use in laparoscopic and thoracoscopic surgery, facilitating improved tissue traction and reducing the inconvenience caused by the chopstick effect in reduced-port procedures.

During MALS, small incisions are made in the patient's abdomen to allow access for the laparoscopic instruments. The instruments are then inserted into the body and guided using the magnetic controller, which allows the surgeon to precisely position and move the instruments to perform the surgical procedure.

MALS has several potential benefits over traditional laparoscopic surgery, including improved precision and control, reduced trauma to surrounding tissue, and reduced risk of complications. It may also result in less pain, shorter recovery times, and smaller scars.

MALS is used in a variety of surgical procedures, including cholecystectomy (gallbladder removal), nephrectomy (kidney removal), and bariatric surgery (weight loss surgery). It is important to note that not all patients are candidates for MALS, and the decision to use this technique depends on the patient's individual medical history and the nature of the surgical procedure.

Several techniques and instruments are utilized for retraction in reduced-port laparoscopic surgery, but these options may lack flexibility. Magnets possess the exceptional characteristic of being able to attract each other without direct contact, and the magnetic anchor device is designed to exploit this quality. By adjusting the position of the anchor magnet, the device allows for modification of the direction and force of the internal grasper's pulling. In our experiment, we discovered that utilizing magnetic force to stretch the gallbladder provided superior versatility in stretching direction, a benefit that is not present in other approaches.

Laparoscopic surgery is a minimally invasive surgical technique that involves the use of small incisions and specialized instruments to perform surgical procedures. While laparoscopic surgery has many advantages over traditional surgery, it also has limitations. One of the main limitations is the limited range of motion of laparoscopic instruments. This can make it difficult to perform certain surgical procedures, especially those that require a high level of precision and accuracy.

Magnetic assisted laparoscopic surgery (MALS) was developed to overcome these limitations. MALS involves the use of magnetic fields to guide surgical instruments through the body, providing a greater range of motion and increased precision.

How MALS Works:

MALS works by using a magnetic catheter to guide surgical instruments through the body. The catheter is inserted into the body through a small incision and is guided using an external magnetic field. The magnetic field is created by a magnetic field generator, which is positioned outside the body.

The catheter is made of a ferromagnetic material, which is attracted to the magnetic field. As the magnetic field is moved, the catheter is guided through the body, allowing surgical instruments to be guided to the site of the surgical procedure.

Applications of MALS:

MALS has a wide range of applications in surgery, including:

    Gastrointestinal Surgery:

MALS has been used in a variety of gastrointestinal surgeries, including the removal of tumors and the repair of hernias. The technique has been shown to be effective in reducing post-operative pain and improving patient outcomes.

    Urologic Surgery:

MALS has also been used in urologic surgery, including the removal of tumors and the treatment of urinary tract obstructions. The technique has been shown to be effective in reducing the risk of complications and improving patient outcomes.

    Gynecologic Surgery:

MALS has also been used in gynecologic surgery, including the removal of ovarian cysts and the treatment of endometriosis. The technique has been shown to be effective in reducing post-operative pain and improving patient outcomes.

Benefits of MALS:

MALS has several benefits over traditional laparoscopic surgery, including:

    Increased Precision:

MALS provides a greater range of motion and increased precision, making it easier to perform surgical procedures that require a high level of accuracy.

    Reduced Trauma:

MALS is a minimally invasive surgical technique, which means that it causes less trauma to the body than traditional surgery. This can lead to faster recovery times and reduced post-operative pain.

    Reduced Risk of Complications:

MALS has been shown to reduce the risk of complications compared to traditional laparoscopic surgery. This is because it allows for more precise surgical procedures and reduces the risk of damage to surrounding tissue.

Limitations of MALS:

While MALS has many benefits, there are also limitations to its use, including:

    Cost:

MALS is a relatively new technology and is still expensive compared to traditional laparoscopic surgery. This can limit its use in some healthcare settings.

    Learning Curve:

MALS requires specialized training, and there is a learning curve associated with its use. This can make it more difficult for surgeons to adopt the technique.

    Limited Applications:

While MALS has a wide range of applications, it may not be suitable for all surgical procedures. Some procedures may require more specialized surgical techniques.

Conclusion:

Magnetic assisted laparoscopic surgery (MALS) is a promising surgical technique that uses magnetic fields to guide surgical instruments through the body, providing a greater range of motion and increased precision compared to traditional laparoscopic surgery. MALS has a wide range of applications in surgery, including gastrointestinal, urologic, and gynecologic surgery. The benefits of MALS include increased precision, reduced trauma, and reduced risk of complications. However, there are also limitations to its use, including cost, a learning curve associated with its use, and limited applications for some surgical procedures.

As technology continues to advance, it is likely that MALS will become more widely available and affordable, allowing more patients to benefit from its advantages. It will also be important to continue to train surgeons in the use of MALS and to develop new techniques and procedures that can take full advantage of its capabilities.

Overall, MALS represents a significant step forward in the field of minimally invasive surgery, and has the potential to improve patient outcomes and reduce the risks associated with traditional surgical techniques. As such, it is an area of active research and development, and is likely to continue to evolve and improve in the years to come.