What is Magnetic-Assisted Laparoscopy / Robotics (MAGS / MARS)

  •  Concept
    Magnetic-assisted laparoscopy refers to the use of magnetic fields and magnetic devices to assist in laparoscopic (minimally invasive) surgical procedures. The idea is that a magnet outside the body interacts with a magnetic component inside the body (often a grasper or retraction instrument), so that certain tasks (like retracting organs or holding tissue aside) can be done without additional incisions or trocars (ports). This reduces the need for extra hands or assistants inside the operative field.
  • Levita MARS
    Levita Magnetics’ MARS stands for Magnetic-Assisted Robotic Surgery. It is a platform that combines magnetic assistance with robotic arms. The system includes surgeon-controlled robotic arms: one to control the external magnetic controller, and another to hold and control the laparoscopic camera. In effect, the surgeon gains enhanced control over both the visual field (camera) and the magnetic retraction, reducing reliance on human assistants.

How It Works Technical / Operational Aspects

  1. Magnetic Retraction Mechanism
    • A magnetic grasper (or a detachable internal instrument) is introduced inside the abdomen via a small incision or trocar.
    • An external magnet (or magnetic controller) placed on the outside of the body exerts force through the body wall to pull or retract organs/tissues. This provides exposure of the surgical field.
    • The coupling (force, stability) depends on body wall thickness, magnet strength, how well the magnet internal tip attaches, etc.
  2. Robotic Integration (MARS Specifics)
    • Levita’s MARS system adds two robotic arms: one robotic arm holds the external magnetic controller so the surgeon can precisely position/reposition it, and the other arm handles the camera (endoscope). This allows the surgeon to control both retraction and visualization.
    • Controls: the surgeon may use hand or foot controls, or possibly direct manipulation, depending on design.
  3. Dynamic Magnetic Positioning™
    • This is the term Levita uses for their magnetic positioning system essentially enabling dynamic control of magnet‐based retraction during surgery, adjusting as needed to maintain exposure.
  4. Indications / Use Cases
    • Initially used for abdominal/laparoscopic surgeries: gallbladder removals (cholecystectomy), bariatric (liver retraction), prostatectomy, colorectal surgery, etc.
    • Also urologic procedures: nephrectomy, adrenalectomy, etc. A clinical study showed good safety and outcomes.

Key Benefits

  • Reduced Number of Incisions / Ports
    By using magnetic retraction, one or more trocars (incisions) used simply for retracting tissue can be eliminated or reduced. This means less trauma to the abdominal wall.
  • Less Pain, Faster Recovery, Fewer Scars
    With fewer incisions and reduced tissue damage, patients tend to experience less postoperative pain, faster healing, and better cosmetic outcomes.
  • Improved Visualization and Surgeon Control
    The surgeon has better control over the camera view, the retraction (via magnet), and is less dependent on assistants. This can lead to more precise exposure of anatomy.
  • Operational Efficiency
    • Fewer staff needed in some parts of the procedure, since assistant roles (holding retractors, managing the external magnet) are reduced. MedTech Dive+2Levita Magnetics+2
    • The system footprint is designed to be compact, so it can fit into standard operating rooms without extensive retooling. Medical Product Outsourcing+1
  • Safety / Clinical Outcomes
    Early clinical trials (e.g. in urology) suggest that the MARS platform achieves good outcomes: no conversions to open in studied cases, short hospital stays, no serious complications, negative margins in cancer surgeries. Learning curve for components like docking time is relatively short.

Limitations, Challenges, and Current Issues

  • Magnetic Coupling Limitations
    The effectiveness of magnetic retraction depends on patient anatomy: thickness of the abdominal wall (body-mass index), presence of fat, distance between magnet exterior and interior parts. In some cases this may reduce force or stability. OAE Publish+1
  • Learning Curve
    Although the learning curve appears manageable (for example in the urology series, docking times improved by case 4), there is still operator training required to use the MARS platform efficiently.
  • Cost & Regulatory Approval
    New devices like MARS require regulatory clearances (FDA etc.), which adds cost and time. Hospitals will need to invest in the systems, train staff, and adapt workflows.
  • Device Size / Strength Trade-offs
    Higher magnetic forces require stronger magnets, which pose safety concerns (jerk, unwanted interactions), require careful design. Also, stronger external magnets may be bulkier or more difficult to position. There may be trade-offs between magnet strength and patient comfort. (These are ongoing engineering challenges.)
  • Scope of Applications / Evidence Base
    While early studies show promise for several abdominal procedures, more data are needed to compare outcomes (long-term, cost, complications) vs standard laparoscopic or robotic surgery. Also, the system may be less effective in certain complex cases or where retracting multiple large organs is needed.

Regulatory Status, Adoption, and Milestones

  • FDA Clearance
    In August 2023, Levita’s MARS platform received FDA 510(k) clearance for abdominal laparoscopic procedures.
  • Use Cases / Clinical Adoption
    By mid-2025, over 1,000 procedures had been performed using MARS globally. Levita Magnetics
  • Combination with Other Robotic Platforms
    There have been procedures combining Levita MARS with other robotic surgical systems (e.g. da Vinci SP) to take advantage of single-port access plus magnetic retraction/neurovascular exposure.

Future Directions

  • Expansion to More Surgeries and Specialties
    As more data accumulate, MARS may be applied to hernia repair, more bariatric procedures, hiatal hernias, colorectal, urology, etc. The indications are expanding.
  • Enhanced Control Interfaces
    Improvements in how surgeons control magnetic components (more ergonomic arms, automated assist, better integration with visualization) are likely to help adoption.
  • Further Integration of Robotics + AI/AR
    Combining this technology with augmented reality (AR) or artificial intelligence for image guidance may enhance precision. Early uses of AR in abdominal surgery with MARS have been reported.
  • Cost Effectiveness Studies
    Long-term studies comparing MARS vs standard laparoscopy or pure robotic surgery (costs, outcomes, recovery times) will be essential to inform hospital procurement decisions.