Directable traction systems and methods
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.
1. A method for performing a surgical procedure, comprising:
introducing a grasper through an opening into an abdominal cavity;
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;
rotating the grasper towards a magnetic control element located outside the abdominal cavity;
applying a magnetic field to the grasper across a body wall; and
moving the magnetic control element over a set of ribs such that the liver bends into a folded configuration.
2. The method of claim 1 , further comprising accessing a space in an abdominal cavity vacated by a portion of the liver.
3. The method of claim 1 , further comprising accessing a stomach in an abdominal cavity vacated by the grasped portion of the liver.
4. The method of claim 1 , further comprising visualizing a stomach in the abdominal cavity vacated by the portion of the liver using an optical sensor.
5. The method of claim 1 , further comprising performing a gastric procedure while the liver forms the fold.
6. The method of claim 5 , wherein the gastric procedure comprises one or more of a gastric bypass, a sleeve gastrectomy, a gastric band procedure, a biliopancreatic diversion with duodenal switch, and a gastric cancer resection.
7. The method of claim 1 , further comprising:
performing a sleeve gastrectomy;
grasping a portion of a right lobe of a liver with the grasper;
rotating the grasper grasping the right lobe towards the magnetic control element located outside the abdominal cavity;
applying the magnetic field to the grasper across a body wall;
moving the magnetic control element over the set of ribs such that the right lobe of the liver bends into a folded configuration; and
cutting a pylorus from a duodenum.
8. The method of claim 1 , further comprising tilting a superior portion of a patient above an inferior portion of the patient.
9. The method of claim 8 , further comprising maintaining a location of the magnetic control element relative to the body wall while tilting the patient and visualizing tissue other than the liver.
10. The method of claim 8 , further comprising repositioning the magnetic control element over the set of ribs while tilting the patient and visualizing tissue other than the liver.
11. The method of claim 1 , wherein grasping the portion of the liver comprises grasping a peripheral edge of the liver.
12. The method of claim 1 , wherein moving the magnetic control element over the set of ribs pulls grasped tissue away from the opening.
13. The method of claim 1 , wherein moving the magnetic control element over the set of ribs moves the control element in a lateral direction.
14. The method of claim 1 , wherein moving the magnetic control element over the set of ribs moves the grasped portion of the liver anteriorly over a right lobe of the liver.
15. The method of claim 1 , wherein moving the magnetic control element is performed in a left-superior direction over the set of ribs.
16. A method for performing a surgical procedure, comprising:
introducing a grasper through an opening into an abdominal cavity;
grasping an inferior portion of one or more of segments IV, V, and VI of a right lobe of a liver with the grasper;
rotating the grasper towards a magnetic control element located outside the abdominal cavity;
applying a magnetic field to the grasper across a body wall; and
moving the magnetic control element over a set of ribs such that the liver bends into a folded configuration.
17. The method of claim 16 , further comprising accessing a space in an abdominal cavity vacated by the grasped portion of the liver.
18. A method for performing a surgical procedure, comprising:
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 magnetic control element located outside the abdominal cavity;
applying a magnetic field to the grasper across a body wall;
moving the magnetic control element over a set of ribs such that the liver bends into a folded configuration;
performing a sleeve gastrectomy;
grasping a portion of a right lobe of a liver with the grasper;
rotating the grasper grasping the right lobe towards the magnetic control element located outside the abdominal cavity;
applying the magnetic field to the grasper across a body wall;
moving the magnetic control element over the set of ribs such that the right lobe of the liver bends into a folded configuration; and
cutting a pylorus from a duodenum.
19. The method of claim 18 , further comprising accessing a space in an abdominal cavity vacated by a portion of the liver.
20. The method of claim 18 , further comprising accessing a stomach in an abdominal cavity vacated by the grasped portion of the liver.