Endosew: new device for laparoscopic running sutures.

Purpose: In 2002, the first completely laparoscopic cystectomy and orthotopic ileal neobladder procedure was reported to take more than 10 hours, with the most time-consuming portion being suturing. Therefore, to improve the quality and reduce the time to place running sutures, we developed a new sewing device for laparoscopic use.

Materials And Methods: We compared running sutures made by hand with those made by machine in the ilea of six pigs. The tightness of the closures was examined and the suturing time recorded. Two animals each were sacrificed after 3, 6, and 9 days, and then the explanted ilea were examined at both the macroscopic and microscopic levels.

Results: No animal died during the course of the experiment and no leaks were found postoperatively. Moreover, no significant differences were seen on macroscopic or microscopic examination in the quality of the two sets of sutures. The time taken to place 1 cm of running suture, including initial preparation, was 7.2 and 3 minutes for hand and machine suturing, respectively. The hand sutures were always initially tight, whereas those placed by machine required adjustment to stop leaks on four occasions.

Conclusion: Using the Endosew device reduces the time needed to place running sutures by 2.4-fold. The quality of the hand- and machine-made sutures was nearly identical at both the macroscopic and microscopic level. Thus, the functionality of this new sewing device is more than satisfactory, and the amount of time saved by using it far outweighs the need for occasional adjustments to stop suture leakage.