A laparoscopic knot-tying device for minimally invasive cardiac surgery.
Identifieur interne : 001201 ( PubMed/Corpus ); précédent : 001200; suivant : 001202A laparoscopic knot-tying device for minimally invasive cardiac surgery.
Auteurs : Shaphan R. Jernigan ; Guillaume Chanoit ; Arun Veeramani ; Stephen B. Owen ; Matthew Hilliard ; Denis Cormier ; Bryan Laffitte ; Gregory BucknerSource :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [ 1873-734X ] ; 2010.
English descriptors
- KwdEn :
- MESH :
- instrumentation : Cardiac Surgical Procedures, Laparoscopy, Suture Techniques.
- methods : Materials Testing.
- Equipment Design, Humans, Models, Anatomic, Sutures, Tensile Strength, Time Factors.
Abstract
Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator.
DOI: 10.1016/j.ejcts.2009.09.024
PubMed: 19854658
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A laparoscopic knot-tying device for minimally invasive cardiac surgery.</title><author><name sortKey="Jernigan, Shaphan R" sort="Jernigan, Shaphan R" uniqKey="Jernigan S" first="Shaphan R" last="Jernigan">Shaphan R. Jernigan</name><affiliation><nlm:affiliation>Department of Mechanical and Aerospace Engineering, North Carolina State University, NC, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Chanoit, Guillaume" sort="Chanoit, Guillaume" uniqKey="Chanoit G" first="Guillaume" last="Chanoit">Guillaume Chanoit</name></author><author><name sortKey="Veeramani, Arun" sort="Veeramani, Arun" uniqKey="Veeramani A" first="Arun" last="Veeramani">Arun Veeramani</name></author><author><name sortKey="Owen, Stephen B" sort="Owen, Stephen B" uniqKey="Owen S" first="Stephen B" last="Owen">Stephen B. Owen</name></author><author><name sortKey="Hilliard, Matthew" sort="Hilliard, Matthew" uniqKey="Hilliard M" first="Matthew" last="Hilliard">Matthew Hilliard</name></author><author><name sortKey="Cormier, Denis" sort="Cormier, Denis" uniqKey="Cormier D" first="Denis" last="Cormier">Denis Cormier</name></author><author><name sortKey="Laffitte, Bryan" sort="Laffitte, Bryan" uniqKey="Laffitte B" first="Bryan" last="Laffitte">Bryan Laffitte</name></author><author><name sortKey="Buckner, Gregory" sort="Buckner, Gregory" uniqKey="Buckner G" first="Gregory" last="Buckner">Gregory Buckner</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="doi">10.1016/j.ejcts.2009.09.024</idno><idno type="RBID">pubmed:19854658</idno><idno type="pmid">19854658</idno><idno type="wicri:Area/PubMed/Corpus">001201</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A laparoscopic knot-tying device for minimally invasive cardiac surgery.</title><author><name sortKey="Jernigan, Shaphan R" sort="Jernigan, Shaphan R" uniqKey="Jernigan S" first="Shaphan R" last="Jernigan">Shaphan R. Jernigan</name><affiliation><nlm:affiliation>Department of Mechanical and Aerospace Engineering, North Carolina State University, NC, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Chanoit, Guillaume" sort="Chanoit, Guillaume" uniqKey="Chanoit G" first="Guillaume" last="Chanoit">Guillaume Chanoit</name></author><author><name sortKey="Veeramani, Arun" sort="Veeramani, Arun" uniqKey="Veeramani A" first="Arun" last="Veeramani">Arun Veeramani</name></author><author><name sortKey="Owen, Stephen B" sort="Owen, Stephen B" uniqKey="Owen S" first="Stephen B" last="Owen">Stephen B. Owen</name></author><author><name sortKey="Hilliard, Matthew" sort="Hilliard, Matthew" uniqKey="Hilliard M" first="Matthew" last="Hilliard">Matthew Hilliard</name></author><author><name sortKey="Cormier, Denis" sort="Cormier, Denis" uniqKey="Cormier D" first="Denis" last="Cormier">Denis Cormier</name></author><author><name sortKey="Laffitte, Bryan" sort="Laffitte, Bryan" uniqKey="Laffitte B" first="Bryan" last="Laffitte">Bryan Laffitte</name></author><author><name sortKey="Buckner, Gregory" sort="Buckner, Gregory" uniqKey="Buckner G" first="Gregory" last="Buckner">Gregory Buckner</name></author></analytic><series><title level="j">European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery</title><idno type="eISSN">1873-734X</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cardiac Surgical Procedures (instrumentation)</term><term>Equipment Design</term><term>Humans</term><term>Laparoscopy (instrumentation)</term><term>Materials Testing (methods)</term><term>Models, Anatomic</term><term>Suture Techniques (instrumentation)</term><term>Sutures</term><term>Tensile Strength</term><term>Time Factors</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Cardiac Surgical Procedures</term><term>Laparoscopy</term><term>Suture Techniques</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Materials Testing</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Equipment Design</term><term>Humans</term><term>Models, Anatomic</term><term>Sutures</term><term>Tensile Strength</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">19854658</PMID><DateCreated><Year>2010</Year><Month>02</Month><Day>22</Day></DateCreated><DateCompleted><Year>2011</Year><Month>01</Month><Day>19</Day></DateCompleted><DateRevised><Year>2014</Year><Month>12</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-734X</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>3</Issue><PubDate><Year>2010</Year><Month>Mar</Month></PubDate></JournalIssue><Title>European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery</Title><ISOAbbreviation>Eur J Cardiothorac Surg</ISOAbbreviation></Journal><ArticleTitle>A laparoscopic knot-tying device for minimally invasive cardiac surgery.</ArticleTitle><Pagination><MedlinePgn>626-30</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ejcts.2009.09.024</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Intracorporeal suturing and knot tying can complicate, prolong or preclude minimally invasive surgical procedures, reducing their advantages over conventional approaches. An automated knot-tying device has been developed to speed suture fixation during minimally invasive cardiac surgery while retaining the desirable characteristics of conventional hand-tied surgeon's knots: holding strength and visual and haptic feedback. A rotating slotted disc (at the instrument's distal end) automates overhand throws, thereby eliminating the need to manually pass one suture end through a loop in the opposing end. The electronic actuation of this disc produces left or right overhand knots as desired by the operator.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">To evaluate the effectiveness of this technology, seven surgeons with varying laparoscopic experience tied knots within a simulated minimally invasive setting, using both the automated knot-tying tool and conventional laparoscopic tools. Suture types were 2/0 braided and 4/0 monofilament.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Mean knot-tying times were 246+/-116 s and 102+/-46 s for conventional and automated methods, respectively, showing an average 56% reduction in time per surgeon (p=0.003, paired t-test). The peak holding strength of each knot (the force required to break the suture or loosen the knot) was measured using tensile-testing equipment. These peak holding strengths were normalised by the ultimate tensile strength of each suture type (57.5 N and 22.1N for 2/0 braided and 4/0 monofilament, respectively). Mean normalised holding strengths for all knots were 68.2% and 71.8% of ultimate tensile strength for conventional and automated methods, respectively (p=0.914, paired t-test).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Experimental data reveal that the automated suturing device has great potential for advancing minimally invasive surgery: it significantly reduced knot-tying times while providing equivalent or greater holding strength than conventionally tied knots.</AbstractText><CopyrightInformation>Published by Elsevier B.V.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jernigan</LastName><ForeName>Shaphan R</ForeName><Initials>SR</Initials><AffiliationInfo><Affiliation>Department of Mechanical and Aerospace Engineering, North Carolina State University, NC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chanoit</LastName><ForeName>Guillaume</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Veeramani</LastName><ForeName>Arun</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Owen</LastName><ForeName>Stephen B</ForeName><Initials>SB</Initials></Author><Author ValidYN="Y"><LastName>Hilliard</LastName><ForeName>Matthew</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Cormier</LastName><ForeName>Denis</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Laffitte</LastName><ForeName>Bryan</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Buckner</LastName><ForeName>Gregory</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R01 HL075489</GrantID><Acronym>HL</Acronym><Agency>NHLBI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 HL075489-01A1</GrantID><Acronym>HL</Acronym><Agency>NHLBI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2009</Year><Month>10</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Eur J Cardiothorac Surg</MedlineTA><NlmUniqueID>8804069</NlmUniqueID><ISSNLinking>1010-7940</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Am J Surg. 2003 Dec;186(6):625-30</RefSource><PMID Version="1">14672769</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Perfusion. 2002 Mar;17(2):103-9</RefSource><PMID Version="1">11958300</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Endourol. 2001 Mar;15(2):187-92</RefSource><PMID Version="1">11325091</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>JSLS. 2004 Apr-Jun;8(2):187-9</RefSource><PMID Version="1">15119668</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Urology. 1995 Aug;46(2):242-5</RefSource><PMID Version="1">7624994</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Surg. 1997 Oct;226(4):421-6; 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