The Endo Stitch 10 mm automated single use suturing device has two jaws. A suture loaded from a single-use loading unit (SULU) is held in one jaw, and can be passed to the other jaw by closing the handles and flipping the toggle levers. The device is designed for introduction and use through appropriately sized trocar sleeves or larger sized trocar sleeves with the use of a converter. The device uses SULUs, available in either single-stitch units with one sutured needle or a triple-stitch unit with three sutured needles. The SULUs are available with several types of sutures:

Bralon sutures - inert, nonabsorbable, sterile surgical sutures composed of the long-chain aliphatic polymers Nylon 6 and Nylon 6.6. The sutures are coated uniformly with polybutylene adipate to enhance handling characteristics, ease of passage through tissue, and reduction of capillarity, and are available either dyed black, with Logwood extract, or undyed (white).

Polysorb sutures - synthetic polyester composed of glycolide and lactide (derived from glycolic and lactic acids). The sutures are prepared by coating them with a mixture of a caprolactone/glycolide copolymer and calcium stearoyl lactylate, and are colored violet to increase visibility, and are also available undyed.

Sofsilk silk sutures - nonabsorbable, sterile, nonmutagenic surgical sutures composed of natural proteinaceous silk fibers called fibroin. The silk fibers are treated to remove the naturally occurring sericin gum. The braided sutures are available coated with silicone to reduce capillarity, and to increase surface lubricity to enhance handling characteristics, ease of passage through tissue, and knot run-down properties.

Surgidac polyester sutures - nonabsorbable, sterile, surgical sutures composed of Poly (Ethylene terephthalate). The monofilament sutures are uncoated and the braided sutures are available uncoated or coated uniformly with polybutylene adipate to increase surface lubricity; they are available dyed with green No. 6 colorant and are also available undyed. The Endo Stitch device and the Bralon, Polysorb, Sofsilk, and Surgidac sutures are products of Covidien (Dublin, Ireland).

Researcher at Duke University Medical Center (Duke, Durham, NC, USA) conducted a study that showed that using the Endo Stitch device during total laparoscopic hysterectomies treating benign conditions was associated with lowering overall hospitalization costs by approximately USD 1,800 and reducing OR time by approximately 40 minutes, on average, when compared to those same procedures performed with robotic assistance. The results were presented at the American Association of Gynecologic Laparoscopists (AAGL) Global Congress of Minimally Invasive Gynecology, held during December 2011 in Osaka (Japan).

“New technologies like automated suturing devices and surgical robots have made suturing inside the body easier, which may increase the number of surgeons who adopt laparoscopic techniques,” said study presenter coauthor Craig Sobolewski, MD, chief of the division of minimally invasive gynecologic surgery at Duke. “While robot-assisted suturing has been shown to be clinically effective, this data indicates that automated suturing with the Endo Stitch device during total laparoscopic hysterectomy in benign cases can be associated with less expensive and more efficient outcomes, when the choice is between the two different enabling intracorporeal suturing technologies.”

Related Links:
Covidien
Duke University Medical Center