UTA, UT Southwestern research is magnetic

Engineers from the University of Texas at Arlington and physicians from UT Southwestern Medical Center at Dallas, with the help of the Johnson & Johnson company Ethicon Endo-Surgery Inc., are moving forward on developing tools that may be attractive to surgeons in the future.

The tools, which rely on strong magnets that attract through the abdominal wall to maneuver within the body, have been the focus of collaboration between the two system sister schools for roughly 10 years, since Dr. Jeffrey Cadeddu, a professor of urology and radiology at UT Southwestern, saw that small magnets could be used to hold studs, negating the need for a piercing.

Staff at UT-ArlingtonÂ’s Automation and Robotics Research Institute, which includes the Texas Manufacturing Assistance Center and is located in Fort Worth, were able to take CadedduÂ’s idea of magnetized surgical tools and work through many prototypes. Richard Bergs, a research associate with TMAC, started research at ARRI as he was finishing his undergraduate degree, and he has been working on further developing this project, called the magnetic anchoring and guidance system (MAGS) for about a decade.

MAGS is expected to be complementary to surgical techniques currently used, such as the growing fields of laparoendoscopic single-site surgery and natural orifice translumenal endoscopic surgery. With LESS, a surgeon works through one incision in the body, reducing trauma to the body, but this technique limits maneuverability as well as the number of instruments that can fit through the incision at once. NOTES uses natural orifices, like the mouth or vagina, to introduce instruments.

“It’s only one hole,” Cadeddu said. “You really can’t stick a bunch of instruments down someone’s mouth to do a lot of surgeries.”

However, a MAGS tool can be put through that incision or opening and the strong magnet it has can be attracted to a magnet on the outside of the body, which the surgeon can move to reposition the tool, he said.

Bergs said that from the beginning, the MAGS tools were meant to be compatible with the tools and instruments surgeons already use.

“As the concept progressed, we embraced this limitation and I

believe this has lead to our continued success,” Bergs said.

Ethicon Endo-Surgery, based in Cincinnati, Ohio, specialized in laparoscopic surgical tools, and Duane Linenkugel, director of concept development for the company, said the company heard about MAGS a few years ago from a presentation at the Society of American Gastrointestinal and Endoscopic Surgeons by Dr. Daniel Scott, associate professor of surgery and director of the Southwestern Center for Minimally Invasive Surgery.

After reaching agreements about collaborating in 2008, the two universities and Ethicon have been further discussing and researching the MAGS tools, hoping to some day move the tools onto the market, Linenkugel said. The working relationship between the engineers at UTA and the doctors at UT Southwestern mirrored the relationship Ethicon tries to have with its collaborators, he said, in that those surgeons on the front lines get the support needed to bring their ideas to fruition.

“It seemed like a pretty comfortable relationship because I think philosophically we work in the same methods,” he said.

Raul Fernandez, program manager of process and design engineering with TMAC, said the relationship has been sustained through the years with regular meetings and correspondence. Robert Eberhard, professor of bioengineering at UT-Arlington, initially put Cadeddu and the engineers in touch with each other, Fernandez said, and this project is just one of a growing number of biomedical projects that are being assisted by TMAC.

While the future holds a great deal more testing and revision for MAGS, “we are past the proverbial garage stage,” Fernandez said. Up to this point, some major things that had to be worked out included how to make sure the magnetic attraction and control stayed strong even as the abdominal wall varied in thickness, and how to ensure the tools were small enough or collapsible enough to fit through a relatively small incision, he said.

The types of tools that could be developed are also numerous, Cadeddu said. Retractors could be put into place to hold tissue or organs out of the way, or a tiny magnetized camera could be anchored in the body to give a surgeon a view of the field. For uncomplicated surgery, like removing a gallbladder, tools with some sort of cauterizing device could be magnetized, he said.

All involved in the MAGS project said the technology elicits positive curiosity from those in the medical fields as well as engineers. While its commercial future has yet to be determined, research will continue—including research locally with the team that developed it. Cadeddu said colleagues are already looking ahead to the best-case scenario.

“To be honest, most people are asking when it’s going to be available,” he said.