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Endoscopic surgery suturing techniques: a randomized study on learning
F J Voskens1,2, E M van der Schans3,4, J P Ruurda5
1Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands. frankvoskens@gmail.com.
BMC Surgery
|February 17, 2022
Summary
The novel FlexDex needle driver showed a longer learning curve and lower suturing quality compared to conventional laparoscopy and robotic systems. Endoscopic suturing with FlexDex requires more training for surgeons.
Area of Science:
- Minimally invasive surgery
- Surgical instrumentation
- Surgical education
Background:
- Surgeons utilize endoscopic suturing with conventional laparoscopic and robotic systems.
- The FlexDex is a new articulating laparoscopic needle driver designed to improve surgical dexterity.
- This study compares the learning curve of endoscopic suturing using conventional laparoscopy, FlexDex, and robotic systems in novice surgeons.
Purpose of the Study:
- To evaluate and compare the learning curve of endoscopic suturing among novices using three different instrument systems.
- To assess suturing task time, quality, and perceived workload for each system.
Main Methods:
- Novice participants performed a minimally invasive suturing task using a conventional laparoscopic needle driver, the FlexDex, and the Da Vinci Si surgical system in a randomized order.
- Primary outcome: suturing task time. Secondary outcomes: suturing quality and workload perception.
Main Results:
- The learning curve was reached in 5 sessions for laparoscopic and robotic systems, versus 8 sessions for FlexDex.
- Laparoscopic and robotic systems demonstrated significantly shorter suturing times and higher quality scores than FlexDex.
- Perceived workload remained high for FlexDex users.
Conclusions:
- Ex vivo endoscopic suturing with FlexDex has a prolonged learning curve compared to laparoscopic and robotic suturing.
- The learning curve for FlexDex differs fundamentally from conventional laparoscopic and robotic instruments.
- Findings offer insights into implementing and training endoscopic suturing techniques.
