V2153: Novel surgical suturing techniques using surgical sewing machines: chronic animal study

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Introduction and Objectives
The history of surgical suturing is over 5,000 years old, but there have been few advances in fundamental principles of surgical suturing which is based on hand sewing. We hypothesized that sewing machines could suture properly on living tissues as well as on non-vital leather fabrics.

Methods
In vitro evaluation, raw cow's stomach was sutured by commercial sewing machine. In animal study, the intestines of four female pigs (55.3 kg, 23 months; 52.0 kg, 23 months; 51.5 kg, 23 months; and 51.8 kg, 23 months) were sutured using the commercial sewing machine with some design modifications. In the first animal, a simulation test that was performed only to confirm the optimal suturing capability of the sewing machine on the vital tissue. In the second and third animal, two-layer longitudinal suturing was performed in two separate parallel suture lines and then incision was made in the middle on the convexity of the small bowel. In the fourth animal, three-layer suturing was performed to close the longitudinal incision on the small bowel. Last three pigs were bred for several days after the procedures.

Results
In vitro test, parallel suture was performed without any problems. Intraoperatively, there was minimal bleeding and no ischemic change in the small bowels of 3 pigs. Excluding the first pig used for the simulation test, the three pigs were fed on a normal diet starting POD 1, and remained healthy until sacrifice. At autopsy, there was no leakage around the suture lines in the small bowels of three animals.

Conclusions
In this pilot study, we concluded that the use of surgical sewing machine to suture the vital tissue is feasible. If we could develop the surgical sewing machine for human use, it would further improve patient outcomes, and revolutionize medical education and medical industry.

Furthermore, digital revolution for the surgical techniques is also anticipated because the movement of machine can be quantified theoretically

Funding: none