Internal Grasper and Magnetic Anchoring Guidance System in Gynecologic Laparoendoscopic Single-site Surgery: A Case Series.

Abstract Study Objective To evaluate and report preliminary data following use of an internal grasper and magnetic anchoring guide system (MAGS) to allow free movements and optimal triangulation in the abdominal cavity during gynecologic laparoendoscopic single-site surgery (LESS). Design A prospective, single-center case series. Setting The First Affiliated Hospital of Xi'an Jiaotong University. Patients Eighteen female patients underwent MAGS-assisted LESS with an internal grasper. Interventions A single surgeon performed MAGS-assisted LESS on patients with benign gynecological diseases while documenting operative time, device insertion time, surgeon assessment of technical adaptation, patient-evaluated pain and cosmetic outcomes, adverse events, and blood loss. Measurements and Main Results Eighteen patients underwent transumbilical MAGS-assisted LESS using an internal grasper from November 2019 to December 2019. Mean operative time and insertion time were 98.7 min and 1 min, respectively. Use of MAGS was easily mastered by the surgeon and considered consistently useful in overcoming the limitations of LESS. Patients reported average pain scores of 4.8, 2.3, and 0.5, immediately, 24 hours, and 1 week after surgery, respectively. All patients expressed satisfaction of postoperative cosmetic results. No serious complications were observed. Mean blood loss was 43.6 mL. Conclusions Use of MAGS-assisted LESS is easy to deploy and use for benign gynecological diseases and appears to result in positive outcomes. Larger randomized controlled trials are warranted.