V09-03: First hand piece type surgical sewing machine using two threads: Animal study for the feasibility of intestinal and vascular use.
Even though its long history, there have been few advances in fundamental principles of surgical suture that is based on hand sewing technique. We had reported a prototype of surgical sewing machine having same functional mechanism with automatic sewing machine on the previous AUA meeting. We have revised design of the initial prototype in order to manufacture the second-generation prototype of the advanced handpiece surgical sewing machine by miniaturizing the various parts with maintaining its functionality and mechanism. We introduce a pilot study to evaluate the new handpiece surgical sewing machine for medical usage.
This prototype is a portable handpiece machine adapting a double-string suture method with 65Ã—28Ã—293 mm in size. The animal experiments were conducted with two adult swine (50kg female). Under general anesthesia, abdominal midline incision. With one pig, small intestine was exposed and incised along the convex border of the small intestine. Then, suturing was conducted with the prototype. With the other pig, renal vascular pedicle was exposed, and the renal artery and vein were dissected. The renal artery and vein were also sutured with this prototype and then nephrectomy was performed (Figure 1). Abdominal incision was closed. The animals were fed on a normal diet starting from postoperative day 1 and were bred for 1 week to observe the acute surgical complication. After 7 days, autopsy was performed to see the small intestine and renal pedicle stump suturing site.
During the initial operation, the suturing was performed with ease in spite of curved margin and curved bowel surface. There was no sign of ischemia in the suturing site and there was no bleeding in mesenteric vessel suture site. Renal artery and vein were sutured with water tight manner without blood leakage. At autopsy, we could see the complete healed suture site in bowel without ischemia and obstruction. The vascular stump was healthy and sealed without bleeding.
This experimental study showed a convenient and easy way to perform the suture in operative field and we concluded that use of the handpiece surgical sewing machine to suture the vital tissue was feasible. But, considering clinical convenience and practical use, more technical development and further study are required.