A Soft Retraction System for Surgery Based on Ferromagnetic Materials and Granular Jamming.

In recent years, minimally invasive surgery (MIS) has gained wider acceptance among surgeons. MIS requires high skills for the operators, mainly due to its intrinsic technical limitations. Tissue manipulation and retraction remain the most challenging tasks; more specifically liver, stomach, and intestine are the organs mostly involved in retraction tasks for abdominal procedures. The literature reports an increasing interest toward dedicated solutions for abdominal tissue retraction tasks. To overcome the limitations of commercial systems and research prototypes, the aim of this study is the design, the realization, and the validation of a retraction system that is simple, reliable, easy to use, safe, and broadly compatible with MIS. The proposed retractor has two main components: (1) a soft central part with variable stiffness obtained by exploiting the granular jamming phenomenon for assuring, at the same time, safe introduction into the abdominal cavity and stable retraction and (2) two iron cylinders located at the two extremities of the device for anchoring the retractor to the abdominal wall by using the magnetic attraction force between these components and two external permanent magnets. System design has been performed by deeply investigating granular jamming principle and ferromagnetic properties of iron elements. Ex vivo and in vivo assessment has been carried out with the final aim to identify the most appropriate design of each retractor component and to demonstrate the advantages of using a soft system with variable stiffness during a retraction task.