Medical Student Research Fellowship for Summer 2009

Mentor: Daniel J. Scott, MD, FACS
Department: Surgery
Room number: E7.116
Mail Code: 9156
Phone number: 214-648-2677
E-mail: Daniel.Scott@UTSouthwestern.edu
Project title: Evaluation of Magnetically Anchored Instruments for Human Surgical Applications

Human subjects IRB approved project number (where applicable): N/A

Animal subjects IRB approved project number (where applicable): APN 2008-0166

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): animal-based and human cadaver-based

Brief Description of Project:

Our lab has been conducting extensive research concerning magnetically anchored instruments that may be suitable for Natural Orifice Translumenal Endoscopic Surgery (NOTES), conventional laparoscopic surgery, or single incision laparoscopic surgery. These instruments are deployed via an access port and then guided and suspended on the peritoneal surface using magnetic coupling to an external handheld magnet. As we further develop these instruments, we wish to conduct studies which aim to document their suitability for use in humans.

Emmanuel Eisenstein is a very bright medical student and has requested to work with our research group this summer. Our proposed request for his involvement is concerning two planned studies.

Project 1: We will evaluate our current version of the magnetically anchored cautery dissector instrument for suitability in humans by performing single incision laparoscopic cholecystectomy procedures in 4 human cadavers. The project's specific goals are to evaluate the instrument in a human anatomical model, determine suitability of instrument reach, and evaluate maneuverability within anatomical constraints including the falciform ligament and costal margin. 3 cadavers are scheduled in June 2009.

Project 2: We will evaluate tissue compression effects of the magnetically anchored system using our current version of the magnetically anchored cautery dissector instrument under static and dynamic conditions on 6 live porcine models. For static testing, 4 magnet instrument pairs will be placed via a laparotomy, coupled across the abdominal wall, left in place for 4 hours, and the abdominal walls will be harvested (immediately, at 48 hours, and at 14 days for 3 animals) with histological analysis performed, evaluating the tissue for inflammatory and vascular changes and signs of tissue necrosis. A similar set of experiments will be conducted for dynamic testing, using a single incision laparoscopic cholecystectomy model and the magnetic cautery instrument, with post-procedure harvest of the right upper quadrant abdominal walls (immediately, at 48 hours, and at 14 days for 3 animals) with histological analysis performed. These experiments will be conducted in July and August 2009.

Emmanuel will attend our regularly scheduled research team meetings, assist with performance of the operations and experiments, assist with collection of data (written data sheets and video capture), assist with analysis of data, assist with assessment of instrumentation short comings, and assist with ongoing collective efforts to generate ideas for instrumentation improvements. Both of the above projects are expected to result in publications; Emmanuel will be authored on these for his research contributions.

Previous Research Activities or Publications with Medical Students:

SPONSOR

" Medical Student Summer Research Externs, UT Southwestern Medical Center, Dallas, TX
Brian Miller, June - August 1998
William Young, June - August 1999
Rishi Taneja, June - August 2000
Philip Ho, June - August 2008

" Medical Student Research Intern, Southwestern Center for Minimally Invasive Surgery, UT Southwestern Medical Center, Dallas, TX
Thomas Sims, July 2001 - June 2002
Alykhan Nagji, January - March 2006

" Medical Student Research Externs, Tulane Center for Minimally Invasive Surgery, Tulane University School of Medicine, New Orleans, LA
Sarah Markley, July - August 2004
John Odero, July - September 2003
Daniel Hayes, June 2003, January 2004

" Postdoctoral Research Fellow, Tulane Center for Minimally Invasive Surgery, Tulane University School of Medicine, New Orleans, LA
Rafael Sierra, MD October 2002 - June 2005 (Matriculated into Surgery Residency July 2005)

" Postdoctoral Research Fellow, Southwestern Center for Minimally Invasive Surgery, UT Southwestern Medical Center, Dallas, TX
Antonio Castellvi, MD, July 2008 - June 2009 (Matriculation into Surgery Residency July 2009)

PUBLICATIONS

UTSW Summer 2008: Philip Ho

1. Castellvi AO, Tang SJ, Hogg DC, Ho PW, Hollett LA, Olukoga CO, Cadeddu JA, Scott DJ. Completely Transvaginal NOTES Using Novel Endoscopic Instrumentation Cholecystectomy in a Porcine Model. Surg Endosc (abstract, in press; manuscript in preparation).

2. Castellvi AO, Tang SJ, Bergs R, Hogg DC, Ho PW, Hollett LA, Fernadez R, Cadeddu JA, Scott DJ. Hybrid Transvaginal NOTES Sleeve Gastrectomy in a Porcine Model Using a Magnetically Anchored Camera and Novel Instrumentation. Surg Endosc (abstract, in press; manuscript in preparation).

(Additional citations for other students is available if needed)