Abstract:

Traditional laparoscopic suturing and knot tying requires a steep learning curve and is often the rate-limiting step in performing advanced laparoscopic gynecologic surgical procedures. It is particularly challenging due to difficulties with tissue handling and needle control while performing the procedure on a two-dimensional screen, oftentimes at unfavorable suturing angles. Automated suturing devices have greatly simplified the process and allow less-experienced surgeons to safely and efficiently perform laparoscopic suturing and knot tying. The Endo Stitch™ (Covidien, Mansfield, MA) is a 10-mm singleuse suturing device that allows placement of multiple suture types during laparoscopic surgery, and simplifies the process of laparoscopic knot tying. The SILS™ Stitch (Covidien, Mansfield, MA) is based on the same technology as the Endo Stitch with the added advantage of articulation up to 75° and rotation up to 360°. This enables surgeons to operate in tight spaces during advanced laparoscopic procedures, and to reach tissues in their natural anatomical position rather than pulling or manipulating tissue into the suturing device. Newer technologies in laparoscopic surgery, such as the Endo Stitch and SILS Stitch, may allow gynecologic surgeons to expand their surgical repertoire of advanced laparoscopic procedures.

Authors:

Stuart Hart, MD, FACOC, FACS, Assistant Professor, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Director, USF Center For The Advancement of Minimally Invasive Pelvic Surgery, Medical Director, Tampa Bay Research and Innovation Center, USF Health Center For Advanced Medical Learning and Simulation (CAMLS) University of South Florida Morsani College of Medicine, Tampa, Florida

PMID: 23225593

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