Laparoscopy Transportation using Magnets and Tramways
1. Laparoscopy Transportation
Using Magnets and Tramways
Daniel A. Tsin, MD (1),
Guillermo Dominguez, MD (2),
Fausto Davila, MD (3),
Andrea Tinelli, MD (4),
Martha R. Davila, MD (5),
Marcelo Martinez Ferro, MD (2)
2. •The Mount Sinai Hospital of Queens; Long Island City, New
•Fundación Hospitalaria; Buenos Aires, Argentina.
•Universidad Autonoma de Mexico, Facultad de Estudios
Superiores; Iztacala, Mexico.
•Vito Fazzi Hospital, Department of Obstetrics & Gynecology,
Division of Experimental Endoscopic Surgery, Imaging,
Technology and Minimally Invasive Therapy; Lecce, Italy.
•Universidad Nacional Autonoma de Mexico (UNAM), GEA
Gonzalez Hospital, DF, México
3. Disclosure of Interest
Dr. Guillermo Dominguez founder of
IMANLAP reports that this financial
relationship had no influence on the
outcome or content of this paper.
Other authors have no financial
interests to disclose.
4. Presented at the Annual Meeting and
Endo Expo of the Society of
SEPTEMBER 5–8, 2012, BOSTON,
This paper presents a means of intra-abdominal transportation without additional laparoscopy ports.
We performed a single incision laparoscopy cholecystectomy using an operative laparoscope with an
operative channel. An alligator clip in tandem with a neodymium magnet was introduced in the
abdomen and placed on the target. A double tether alligator (Secured Independent Tool) was
introduced using two 18 gauge IV catheters strategically placed under laparoscopic surveillance. A
suture was threaded through the IV catheter and identified with the endoscope as it entered the
cavity. The suture was grasped and withdrawn until exiting via the operative port; this maneuver was
done twice. Outside the port, the sutures were tied to the Secured Independent Tool. The Secure
Independent Tool was introduced and placed on the target.
The magnet was used to hold the fundus of the gallbladder and transport the endobag. The Secured
Independent Tool was used for exposure, mobilization and transportation of the gallbladder. No
perforation of the gallbladder occurred and all functions were done successfully.
Magnet transportation in the anterior peritoneum was unlimited in this case. The strategically placed
IV catheters allow for an aerial type of tramway transportation of a target between two points inside
8. A: Internal
B: Alligator Clip
Magnet and the
Semin Pediatr Surg. 2011 Nov;20(4):224-31.
The use of magnets with single-site umbilical laparoscopic
Padilla BE, Dominguez G, Millan C, Martinez-Ferro M.
13. After de-roofing, the internal magnet transported the specimen to the pelvis in order to
facilitate the vaginal extraction. We see the roof of the liver cyst with the attached
14. “Secured Independent Tools (SIT) is changing the
Laparoscopy paradigm. “
1 port per instrument. Multiple instruments
Cannulas. Threads or Cables.
The diameter of the port The diameter of the
is larger that the cable or thread is
instrument. smaller that the
15. The intravenous catheter is thread with a 2-0 prolene, which
is grasped and withdrawn via a 12 mm port . The end is
then tied to an alligator clip. To make a tramway, 2
intravenous catheters must be placed at strategic points.
J Laparoendosc Adv Surg Tech A. 2012 May;22(4):397-9. Epub 2012 Mar 6.
Transabdominal wall deployment for instruments, lights, and
micromotors using the concept of secured independent tools.
Tsin DA, Davila F, Dominguez G, Tinelli A, Davila MR.