Endoscopic suturing device using new reciprocating curved needle: An Ex Vivo comparison study

Abstract

Many operation methods have been developed in an attempt to minimize operative stress. Gastrointestinal endoscopic surgery is a novel method in which a natural orifice is used to approach the target organ. With the endoscopic surgery, suturing is particularly important. The goal of this study is to develop an endoscopic suturing device and to demonstrate the feasibility of the device by showing the strength of closure. In the endoscopic closer (En-closer) technique, the wound is sutured with a curved needle using a reciprocating movement. After the mechanism implementation, we carried out a feasibility study on 10 porcine stomach models. Air leakage pressure was used to determine the strength of the perforation closure. Each endoscopic clip (endoclip) method and fullthickness stitches involved hand suturing was used 10 times to increase reliability. The average leakage pressure for the En-closer was 43.25mmHg. The average closer strength of the En-closer does not significantly differ from that of the endoclip, but standard deviation of the En-closer is significantly smaller than that of the endoclip. The En-closer had similar closure strength to that of the endoclips but showed a more consistent sequence than the endoclips. This research proposes a new approach for endoscopic suturing devices.