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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
PubMed
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This summary is machine-generated.

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.
Keywords:
Laparoscopic suturingLearning curveMedical robots and systemsRobotic suturingSurgical robotics

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  • 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.